Case 48: This is a good example of finesse rhinoplasty where subtle changes can make for a very nice and meaningful difference. This young woman liked the overall shape of her nose but wanted it slightly smaller in all dimensions to match her pretty, petite features. We were able to achieve these goals by always relying on techniques that produce stable and precise results. Subtle fat transfer to the under eye area further helped to reduce under eye circles and soften her overall look.
How much you’ll swell really depends on you and on your surgeon’s technique—not so much the type of rhinoplasty you had. Dr. William Portuese, a facial plastic surgeon in Seattle, says that “The amount of swelling after a rhinoplasty procedure depends upon the type of rhinoplasty performed [open versus closed], the thickness of the skin, the amount of alteration required to the nasal tip, and the patient’s variability with the healing process itself.” He notes that “Some patients require taping and steroid shots in the tip of the nose to reduce swelling in that area for the first several months after the procedure.” According to Dr. Miller, “A very clean open rhinoplasty can result in minimal swelling, while with a closed procedure that isn’t performed in the ideal tissue and cartilage, you can have a lot more swelling. If the dissection travels through soft tissue or muscle on top of the cartilage, more bleeding and swelling will develop.” He notes that most people can also expect some bleeding from days two to five, but it should lessen with each passing day.
Case 72: This patient had sustained a nasal fracture that caused a significant deviation of her nose. The fracture was corrected along with a septoplasty to improve breathing. Loss of tip support after the injury made her hump look more prominent and her tip felt more droopy. The bump was smoothened and her tip angulation restored to create the softer, more feminine profile she wanted. At the same time, fat transfer to the cheek and under eye area and subtle neck liposuction substantially improved the flat cheek and mid-face contour that previously made her feel hollowed and tired looking without makeup.
Case 87: This young woman had broken her nose and was noticeably crooked with poor nasal breathing. In addition, she disliked her nasal hump and length. She preferred an aesthetic with a slight supra tip break to soften her profile. Beyond straightening and improving her breathing, you can see how we were able to remove the nasal hump and lift her tip to transform her look while still looking completely natural.
Case 25: This patient had what is called a tension nose wherein a convexity on the bridge pushes the tip forward and down. Notice how this also puts tension on the upper lip and appears to tether it from inside. a combination of straightening, improving breathing, removing the hump, and setting the tip appropriately also helps to relax the upper lip and complete the look.
Case 44: One of the hardest things to accomplish in a nose job is giving a person a smaller version of the same nose. In Los Angeles, where small differences can mean everything, doing Finesse Rhinoplasty is common. Even at 6 months, you can see that, on profile, this patient’s tip is less projected but he still has a strong masculine profile. On base view, you will also notice the deprojection and the fact that alar base reduction can be done with no visible scars and maintenance of the natural nostril curve.
Your surgeon should give you aftercare instructions for changing your bandages and cleaning your incisions to prevent infection. They’ll also let you know when your drains and any stitches can come out. Until then, sleep on your back or side, avoid lifting heavy things, and follow your doctor’s recommendations for when you can go back to your regular routine, including sex.
A Bra Lift with Laser (Laser Bra Lift): Some doctors will want to use a laser bra lift as an insurance policy that your breasts won’t sag. It’s actually not really an alternative to breast lift surgery as it is an extra procedure. In the laser bra surgery, the laser is used to create a bra-like effect that protects the surgical results of the breast lift. Laser energy will always stimulate the production of new collagen fibers, which give you more support of any tissues. Always look at the before and after pictures to see whether or not you think there is enough improvement.
The traditional breast lift reshapes the breast by removing tissue. This improves only the lower part, at and below the nipple. It does nothing for the area above your nipple. While this does eliminate sagging, it does not improve the roundness of your breasts. With time, a breast that's been lifted using traditional techniques will start to take on an odd flattened out, tubular appearance, because all the tissue is in the bottom part. To prevent this, many women get implants. But why bother with implants if you don't need them?
Case 29: Major concerns for this patient were widening of the tip with a marked lack of projection which made his nose feel flat and washed out. Nostril thickness and rounding was also something he wanted addressed. In this case, irradiated donor rib cartilage was used to project and support the tip along with alar base reduction removing a significant amount of nostril flare to create a natural tip and nostril contour that is ethnically appropriate. Fat transfer to the cheeks helps to balance out his flat mid-face to strengthen the cheek contour which can be seen nicely on the profile view.

When performing your breast lift, your surgeon will make every effort to make incisions in easily concealed locations, but scarring is an unavoidable byproduct of any surgery. Breast lift scars do fade over time, but in some cases, will never completely disappear, and may be permanently visible. If scarring is a concern for you, we’ll be happy to discuss scar reduction methods with you.
When performing your breast lift, your surgeon will make every effort to make incisions in easily concealed locations, but scarring is an unavoidable byproduct of any surgery. Breast lift scars do fade over time, but in some cases, will never completely disappear, and may be permanently visible. If scarring is a concern for you, we’ll be happy to discuss scar reduction methods with you.

A curvature and droopy tip brings undue focus to this young man’s nose. Although there is still some swelling in these early post-operative photos, we can already see a nose that is now straight, has a smooth profile and no longer droops. A sense of length is preserved to match his oval face. More than that, because of these positive changes, he also looks younger.


Case 47: This patient’s primary surgery left her with valve collapse, nostril notching, persistent tip rounding and hanging columella. Secondary surgery involved correction of these issues with repositioning and reconstruction of the tip cartilages to improve tip contour. Although she is still a little swollen in the after photos, she is already happy with her new nose.
The results are usually permanent, aside from normal changes that come with the aging process. If you’re really not happy with your results or have breathing difficulties once your nose has healed, you may be a candidate for a revision rhinoplasty. In many cases, scar tissue is the main culprit. “The force of a scar is very strong,” says Dr. Miller. “It can pull a nose one way or another—push it in, pull it out, turn it.” When this happens, a surgeon has to go back in and tweak the work. 
Case 4: Some might think that this patient had had previous rhinoplasty with tip collapse, but she did not. Occasionally, the shape of the tip cartilages is very vertically-oriented, causing a deep groove in the nostril. She felt this, along with her marked tip crookedness, drew unwanted attention to her nose. Now, her nose is smaller, smoother, more defined, and just blends with the rest of her face.
Your breasts will be bruised and swollen for the first few weeks, and they’ll probably feel heavy and tight. According to Dr. Ted Eisenberg, a Philadelphia plastic surgeon, in a RealSelf Q&A, “women report minimal discomfort after breast lift surgery.” But you should have pain medication prescribed for the first few days, just in case you need it. After that, Tylenol should do the trick.
Case 38: This beautiful young lady is an early 6 month example of a finesse rhinoplasty. On front view you can see the bridge is narrower and the sense of hang is improved. On profile, the tip looks undone, natural and less projected with correction of the slight hanging columella. The result is a beautiful, natural look that corrects the issues but leaves her looking totally natural and undone.
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