The closed vs. open rhinoplasty technique concerns only how the surgeon gets inside the nose to make the required changes, not what’s accomplished with the rhinoplasty procedure itself. Reshaping your nose may include breaking and removing bone and cartilage. If cartilage needs to be added, say, to rebuild the tip of the nose, it’s often taken from the septum, the middle portion of the nose—a technique called a cartilage graft. Cartilage may also be taken from other areas of your body, such as your ear. In some cases, a synthetic material, like a silicone implant, is used; but studies have shown that there may be more complications with synthetics. Cartilage grafts, nasal-bone osteotomies (removal of parts of the bone), dorsal-hump removal, and suture techniques applied to the nasal tip cartilages can all be performed with either the closed- or open-approach rhinoplasty.
During the course of a woman’s life, the breasts change in appearance and oftentimes sag. Don’t worry, this is NOT an uncommon condition. In fact, the clinical term for female breasts that sag is called ‘breast ptosis.’ There are many causes of breast ptosis including pregnancy, cigarette smoking, high body mass, gravity and the natural aging process. There are also different degrees of ptosis as shown in the illustration below. Fortunately, breast ptosis can easily be treated with breast lift surgery.
A revision rhinoplasty is a complicated surgery, because the surgeon now has to contend with thick scar tissue—which makes it difficult to raise the skin and soft tissue off the cartilage. “Plus, we often need to reconstruct part of the nose, so we need to take cartilage from other sources,” says Dr. Miller. Surgeons say that the minimum amount of time to wait before you can do revision rhinoplasty, even if there is an obvious problem, is a full year. 

Case 89: This patient had broken her nose with consequent severe loss of tip support, tip rounding, crookedness, and a traumatic bump. In this case, a lateral crural overlay technique was used to reduce and lift the tip along with a septal extension to help with support and straightening which has improved tremendously as seen on the base view. Even though she’s still swollen in these early photos, she already has a great result and it’s only going to get better. 

A: It’s difficult to answer “how much” sensitivity you can expect to lose after breast lift surgery but most patients report that they are able to retain complete or near complete sensation. During the initial postoperative period, there may be a temporary loss or decrease in sensation primarily due to swelling. As the swelling subsides, the sensation will return. There is the potential that you may experience a change in the sensitivity of your nipples and the skin of your breast. On occasion, patients have reported that their nipples are “supersensitive.” In this case desensitization, exercises can be performed to diminish the sensitivity. This involves gently rubbing the nipples with cotton ball and then progressing to a more course material.
Case 21: For our patients who are in image-centered occupations such as modeling or acting, nasal refinements often focus on small changes that will enhance the overall look and remove subtle cues about the nose that preoccupy or distract the eye. This successful model had a look that really worked for her but had always felt that her tip and nostrils were too wide, flared, and slightly droopy. Creation of a slightly narrower and more structured tip draws unwanted attention away from her nose and, instead, enhances her overall look.
A: It’s difficult to answer “how much” sensitivity you can expect to lose after breast lift surgery but most patients report that they are able to retain complete or near complete sensation. During the initial postoperative period, there may be a temporary loss or decrease in sensation primarily due to swelling. As the swelling subsides, the sensation will return. There is the potential that you may experience a change in the sensitivity of your nipples and the skin of your breast. On occasion, patients have reported that their nipples are “supersensitive.” In this case desensitization, exercises can be performed to diminish the sensitivity. This involves gently rubbing the nipples with cotton ball and then progressing to a more course material.

Case 60: Facial aging can be hard on someone who is naturally thin by creating a more severe and skeletonized appearance as facial fat is lost. A combined approach was used to create a beautiful transformation, including a trichophytic brow lift, lower lid tightening, and facelift along with a conservative rhinoplasty to straighten and balance her nose. Notice how the eyes are opened up and facial hollows are smoothened without the surprised look that can accompany over-aggressive lifts. You’ll also see that incisions are hidden within the hairline and natural skin creases making them almost invisible.
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.

During the course of a woman’s life, the breasts change in appearance and oftentimes sag. Don’t worry, this is NOT an uncommon condition. In fact, the clinical term for female breasts that sag is called ‘breast ptosis.’ There are many causes of breast ptosis including pregnancy, cigarette smoking, high body mass, gravity and the natural aging process. There are also different degrees of ptosis as shown in the illustration below. Fortunately, breast ptosis can easily be treated with breast lift surgery.
An “Internal” Bra: This is one of the most interesting procedures, as it is a mesh type of bra that is inserted surgically to lift your breasts. The mesh bra provides a little extra structure although over time the mesh is broken down and absorbed by your own tissues. This procedure is called the Breform, and you can expect a surgery of about four hours in the hospital with a few nights in recovery before you are released. The Breform is inserted through a scar in the nipple area or in the crease under the breast.
Back in December 2017, Markle caused a spike in attention in Scottish merchant Strathberry after carrying among the handbags into a community occasion soon after her participation. It was reported as a sign that her style choices would create her very own version of this Kate effect. It’s been theorized that Markle’s impact could be higher, as she’s an intense fascination in us. Following Markle and Prince Harry’s very first look at a few, manufacturers Mackage, Birks, R&R Jewelers, Crown Jewelers, and Everlane noticed an upswing in their site hits and earnings.
Case 12: One of the things that we love about rhinoplasty is that we can combine dramatic changes such as straightening this patient’s nasal twist, and at the same time create some subtle enhancements such as refining and slightly deprojecting the tip while reducing the sense of columellar show. At 6 months, her nose now balances with her face and really brings out her beautiful eyes.
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.
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