Your surgeon can change the shape of your nasal bones or cartilage in several ways, depending on how much needs to be removed or added, your nose's structure, and available materials. For small changes, the surgeon may use cartilage taken from deeper inside your nose or from your ear. For larger changes, the surgeon can use cartilage from your rib, implants or bone from other parts of your body. After these changes are made, the surgeon places the nose's skin and tissue back and stitches the incisions in your nose.
Then he took a bunch of pictures from different angles and stepped out to review them. A few minutes later, we sat down in his office to go over the images. He showed me three distinct perspectives: front, profile, and from below, which he called the worm's-eye view. With each photo, he presented a revised image of what my nose could look like with surgery — and, wow, what a rush of happiness! It was honestly everything I was hoping for: smoother and smaller, but still me.
Contoured implants, also called anatomical or teardrop-shaped implants, are shaped like a natural breast and create a sloped shape when placed over the chest muscles. Round breast implants have that, well, "round" Victoria's Secret or Playboy model shape. Contoured implants may flip over if the surgeon does not create the pocket correctly, resulting in a misshapen breast. Not true with round implants. If a round breast implant flips, it still looks the same. Your decision on implant shape should be based on how you want your new breasts to look.
The ‘gummy bear’ implant comes in both round and teardrop shapes. They have a firmer gel, which may give a better shape and may last longer. The round gummy bear implant is often a good choice for women with looser tissues and who want a more durable implant that remains soft. The teardrop shaped gummy bear implant may be a good choice for women whose tissues are relatively tight and desire a very proportionate and natural looking enhancement with less fullness of the upper portion of the breast and more projection and fullness of the lower portion of the breast.

The breast implant has no clinical bearing upon lumpectomy breast-conservation surgery for women who developed breast cancer after the implantation procedure, nor does the breast implant interfere with external beam radiation treatments (XRT); moreover, the post-treatment incidence of breast-tissue fibrosis is common, and thus a consequent increased rate of capsular contracture.[108] The study Breast Cancer Detection and Survival among Women with Cosmetic Breast Implants: Systematic Review and Meta-analysis of Observational Studies, reported an average later stage in the diagnoses of women who developed breast cancer after undergoing breast augmentation, when compared to breast cancer patients who had not undergone breast augmentation, although this did not ultimately affect the patients prognosis. The use of implants for breast reconstruction after breast cancer mastectomy appears to have no negative effect upon the incidence of cancer-related death.[105][109]
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.
Placement: The area designated to receive the graft will then be prepared. Your surgeon will insert a needle or cannula into the incision point of the site being augmented. The injection needle is usually passed in and out of the areas to be augmented multiple times. Each time the needle or cannula is withdrawn, a line of fatty tissue parcels is carefully deposited in natural tissue planes. This process is repeated until the desired correction has been achieved, creating a grid of grafted fat. Some surgeons recommend massaging the grafted areas to create a satisfactory contour. Others prefer to rely on the placement technique to create the appropriate contour. The surgeon may also place a dressing or bandage over the grafted area.
Fat transfer surgery is a hot topic among today’s elite plastic surgeons. Dr. Mess researched and trained in fat transfer during her six-year residency at Georgetown University Hospital and incorporated the procedure early in her practice. She has refined her technique to offer the advantages of fat transfer to augment and reconstruct. Dr. Mess performs fat transfer to the face, breast, hands, and buttocks to add volume and fullness and restore a youthful and vigorous appearance.

Case 16: A crooked and overprojected nose draws the eye away from other beautiful features. In this pretty young woman, you can see how rhinoplasty transforms her face. Even at this early 3-month point, we see that her nose is more feminine and no longer dominates her otherwise delicate features. And, at the same time, it is balanced and ethnically-appropriate.
For the first part, even though you did not post photos, based on your height and weight you would have plenty of fat to be able to take in my opinion. The relative limit on how much can be removed and send you home the same day safely is about 5 liters of liposuction/fat. I think you would easily be able to get to this upper limit based on your height and weight.
When the patient is unsatisfied with the outcome of the augmentation mammoplasty; or when technical or medical complications occur; or because of the breast implants’ limited product life, it is likely she might require replacing the breast implants. Common revision surgery indications include major and minor medical complications, capsular contracture, shell rupture, and device deflation.[44] Revision incidence rates were greater for breast reconstruction patients, because of the post-mastectomy changes to the soft-tissues and to the skin envelope of the breast, and to the anatomical borders of the breast, especially in women who received adjuvant external radiation therapy.[44] Moreover, besides breast reconstruction, breast cancer patients usually undergo revision surgery of the nipple-areola complex (NAC), and symmetry procedures upon the opposite breast, to create a bust of natural appearance, size, form, and feel. Carefully matching the type and size of the breast implants to the patient's pectoral soft-tissue characteristics reduces the incidence of revision surgery. Appropriate tissue matching, implant selection, and proper implantation technique, the re-operation rate was 3 percent at the 7-year-mark, compared with the re-operation rate of 20 per cent at the 3-year-mark, as reported by the U.S. Food and Drug Administration.[64][65] 

From the first half of the twentieth century, physicians used other substances as breast implant fillers—ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol—formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.[111]
Fat transfer, is a safe, natural, minimally invasive procedure. Fat from one area of your body is transferred to another part of your body –hence the name, “fat transfer”. How it works is some parts of your body may have excess fat that can be utilized by areas that have lost their fullness or in areas that never had it in the first place. Some of these areas can be thin lips, calves, cheeks, breasts, hands, pock marks, buttocks, scars, and marks from previous cosmetic procedures. Many choose to have a fat transfer procedure with a combination of an Breast Lift to reduce sagging breasts.
Placement: The area designated to receive the graft will then be prepared. Your surgeon will insert a needle or cannula into the incision point of the site being augmented. The injection needle is usually passed in and out of the areas to be augmented multiple times. Each time the needle or cannula is withdrawn, a line of fatty tissue parcels is carefully deposited in natural tissue planes. This process is repeated until the desired correction has been achieved, creating a grid of grafted fat. Some surgeons recommend massaging the grafted areas to create a satisfactory contour. Others prefer to rely on the placement technique to create the appropriate contour. The surgeon may also place a dressing or bandage over the grafted area.
Saline-filled Breast Implants. Saline-filled breast implants are filled with sterile saline (salt water). They come in both smooth and textured shells and can be round or anatomically (tear-drop) shaped. Saline breast implants are also available in low and high profiles, and in many sizes. A saline-filled breast implant is usually empty before implantation. The doctor moves it into place during your surgery, and then fills it. The saline is administered via a process that ensures the implants remain sterile.
When you choose a breast implant, you are choosing a device that will be part of your body for many years. Breast implants are not lifetime devices, but if your implants do not encounter complications, there is no reason for a revision. Your implants could be with you for over 30 years, so you should spend some time weighing the benefits and compromises of each implant type. Pick an implant that you feel comfortable with, but also gives you great results. The IDEAL IMPLANT Structured Breast Implant the lowest rates of rupture and capsule contracture in primary augmentation at 8 years, but still gives women a beautiful, natural look and feel. Silicone gel breast implants give women beautiful results, but at an increased financial strain and emotional toll, Dr. Mahony tells us.
If your breast implants rupture, or you develop capsular contracture (two of the top reasons for revision surgery according to the FDA), you will need surgery to correct the issue. You can choose to remove your breast implants with or without replacement. This surgery will be similar in cost to your primary breast augmentation, or could be higher depending on the complexity. Again, health insurance companies do not usually cover costs associated with breast implants, even if you have a medical reason to remove them. As stated above, warranties may or may not cover costs as well.

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.

No. Rhinoplasty is a challenging operation. This is due to several factors. First, the nose is a complicated 3D shape that is in the middle of the face. Changes made during rhinoplasty are often very small. But these changes can make a major difference in the way the nose looks and functions. Because these changes are small, so is the margin for error.
Cosmetic surgeons may use the “crescent lift” technique for women who have a very small amount of sagging to correct. This involves a small incision running halfway around the top half of the edge of the areola. Usually, a crescent lift is only done when a patient is also having breast augmentation, and even in these cases the crescent incision type is less frequently used.
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.
Both breast reduction and breast lift surgeries are similar in that they both serve to reshape the breasts. Breast lift, through any of the various techniques, basically serves to reposition the breast and nipple on the chest to reverse the effects of time and gravity. The same changes that are noted in ptotic, or sagging, breasts are often seen in large breasts that require reduction: the nipple position is often low and there is excess skin (in addition to the excess breast tissue). The breast reduction then combines a lift with removal of extra tissue to create a breast that has a higher nipple position, reduced extra skin, and smaller and more balanced breast size.
Manufacturer’s warranty programs can mitigate some of the costs of treating complications. But, the warranty payment is only available if a rupture is detected. Some surgeons fail to inform their patients of the need for periodic MRIs, or downplay the FDA recommendation in order to make a sale. “Many women don’t know about the maintenance costs and potential expenses of silicone gel implants,” reports Dr. Ellen Mahony, board-certified plastic surgeon in Westport, CT.  “Because rupture with a silicone gel implant is ‘silent,’ it can go undetected for an extended period, often not becoming obvious until the process of capsular contraction has begun.” Capsular contraction leads to a more complex surgery. That means added surgical costs which your warranty may not cover.
The plastic surgical emplacement of breast implant devices, either for breast reconstruction or for aesthetic purpose, presents the same health risks common to surgery, such as adverse reaction to anesthesia, hematoma (post-operative bleeding), late hematoma (post-operative bleeding after 6 months or more),[21] seroma (fluid accumulation), incision-site breakdown (wound infection). Complications specific to breast augmentation include breast pain, altered sensation, impeded breast-feeding function, visible wrinkling, asymmetry, thinning of the breast tissue, and symmastia, the “bread loafing” of the bust that interrupts the natural plane between the breasts. Specific treatments for the complications of indwelling breast implants—capsular contracture and capsular rupture—are periodic MRI monitoring and physical examinations. Furthermore, complications and re-operations related to the implantation surgery, and to tissue expanders (implant place-holders during surgery) can cause unfavorable scarring in approximately 6–7 per cent of the patients. [22][23][24] Statistically, 20 per cent of women who underwent cosmetic implantation, and 50 per cent of women who underwent breast reconstruction implantation, required their explantation at the 10-year mark.[25]
Placement: The area designated to receive the graft will then be prepared. Your surgeon will insert a needle or cannula into the incision point of the site being augmented. The injection needle is usually passed in and out of the areas to be augmented multiple times. Each time the needle or cannula is withdrawn, a line of fatty tissue parcels is carefully deposited in natural tissue planes. This process is repeated until the desired correction has been achieved, creating a grid of grafted fat. Some surgeons recommend massaging the grafted areas to create a satisfactory contour. Others prefer to rely on the placement technique to create the appropriate contour. The surgeon may also place a dressing or bandage over the grafted area.
It is also possible for implants to rupture and leak. If saline implants rupture, the saline will be safely absorbed by the body. A silicone leak may stay inside the implant shell or leak outside of the shell. When a saline implant ruptures, it will deflate. But silicone breast implants may cause no obvious symptoms when they rupture. This is called silent rupture.
For the second part....it depends where your butt is starting at. There is a point in which there is too much pressure in the butt that no more fat can really be injected. Pressure kills the fat cells (which is why you cannot sit on the butt for a few weeks after surgery). It also means that we cannot just keep injecting if the gluteus has fully expanded and is not able to take any more. If you are starting with a small butt.....there is a smaller limit. If you are starting with a medium sized butt.....there is a bigger limit. I like to use power assisted "vibration expansion filling" to really push the boundaries of how much fat can be injected into the buttocks. This helps to expand the buttocks on the table and get more fat into more stubborn areas. Typically, even for smaller girls, I will inject at least 1000ml per side (and up to 1600ml for larger girls). After this, as you have probably read, 30-50% of the fat will either reabsorb or "not take". However, with the removal of a large amount of fat around your midsection combined with careful technique and contouring of the butt and hips, we can make a very large difference in your overall proportion. Best of luck to you!
Once we set a date for surgery, Dr. Kolker prescribed various vitamins (C, B12, and zinc) to start taking one week prior to surgery to prep my body for the trauma and help speed recovery. I'd have to avoid red wine and blood thinners (like Advil) for two weeks beforehand. He prescribed pain medication, too, but said I may only need Tylenol post-op because the discomfort isn't all that bad. There would be lots of bruising and swelling, but after six weeks, he said, my appearance should be back to normal, only with a better nose. After three months, I'd be 75 percent healed, but the swelling wouldn't fully subside for one year.

Arm LiftBody ContouringBody LiftBotulinum ToxinBreast AugmentationBreast Implant Removal & ExchangeBreast LiftBreast ReconstructionBreast ReductionBrow LiftButtock Lift with AugmentationChin AugmentationCleft Lip and PalateCraniosynostosis SurgeryDermal FillersEar SurgeryEyelid SurgeryFaceliftGynecomastia SurgeryHair TransplantLip AugmentationLiposuctionRhinoplastyThigh LiftTummy Tuck


Sucking fat from your hips and thighs and injecting it into your boobs or butt may seem like a dream come true—and for some, it is. The process, called fat transfer or fat grafting, involves removing fat from one part of the body via a gentle liposuction, and then injecting it elsewhere. It works well all over the body, but is most commonly used on the face to enhance cheeks, fill hollow lower eyelids, and build up areas that have lost volume due to aging, explains New Jersey plastic surgeon Parham Ganchi, M.D. It’s also commonly used to plump up butts and to increase breast size and improve breast shape.
The ‘gummy bear’ implant comes in both round and teardrop shapes. They have a firmer gel, which may give a better shape and may last longer. The round gummy bear implant is often a good choice for women with looser tissues and who want a more durable implant that remains soft. The teardrop shaped gummy bear implant may be a good choice for women whose tissues are relatively tight and desire a very proportionate and natural looking enhancement with less fullness of the upper portion of the breast and more projection and fullness of the lower portion of the breast.
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