Photographs. Someone from your doctor's office will take photographs of your nose from different angles. Your surgeon may use computer software to manipulate the photos to show you what kinds of results are possible. Your doctor will use these photos for before-and-after assessments, reference during surgery and long-term reviews. Most importantly, the photos permit a specific discussion about the goals of surgery.
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.
Dr. Kolker then laid out his surgical plan for me: He'd perform an open rhinoplasty, explaining that the difference between an open and closed procedure amounts to a small incision on the underside of the columella (that skinny strip of skin between the nostrils), which can be seen only from below and fades rapidly. Both procedures require incisions inside the nose, but an open rhinoplasty adds that small columellar incision.
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.
Subfascial: the breast implant is emplaced beneath the fascia of the pectoralis major muscle; the subfascial position is a variant of the subglandular position for the breast implant. The technical advantages of the subfascial implant-pocket technique are debated; proponent surgeons report that the layer of fascial tissue provides greater implant coverage and better sustains its position.
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.
Platinum is a catalyst used in the making of silicone implant polymer shells and other silicone devices used in medicine. The literature indicates that small amounts of platinum leaches (leaks) from these implants and is present in the surrounding tissue. The FDA reviewed the available studies from the medical literature on platinum and breast implants in 2002 and concluded there was little evidence suggesting toxicity from platinum in implant patients. The FDA revisited this study and additional literature several years later, reaffirming prior conclusions that platinum catalysts used in implants is likely not ionized and therefore would not represent a risk to women.
Sometimes insurance pays for a rhinoplasty, but it depends on the insurance policy. Before scheduling surgery, your doctor's office will help you get prior written authorization from your insurance company. Although this isn't a guarantee of coverage, it's the only way to confirm that rhinoplasty is a covered benefit. Sometimes insurance will pay for a part of a nasal surgery, but not other parts. In these cases, you can contact the business office to get a quote for the operation.
Many different types of breast lifts are now available in conjunction with a breast reduction, including lifts just around the areola (periareolar), vertical/lollipop mastopexies (incision around the areola and down to the breast fold, and full breast lifts with an anchor incision. For patients who have very loose skin in the armpit or back, axillary or bra lifts are also often combined with breast reductions.
The Summary of Safety and Effectiveness for each of the FDA-approved saline- and silicone gel filled breast implants details safety information known at the time of FDA approval. As the FDA learns of new safety information, it requires companies to update their product labeling. The most current safety information about saline- and silicone gel-filled breast implants can be found in the labeling.
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!
When I moved to New York City after graduation, and began establishing myself and building a career, I suddenly felt the time was right to revisit the procedure. I met with Adam Kolker, a well-known plastic surgeon here in New York City, and immediately felt safe and heard. I respected his delicate, conservative approach and appreciated how he spent real time listening to my concerns and making sure I felt comfortable.
Unfortunately, as time goes on it is often difficult for patients to remember the specifics of the type of breast augmentation surgery and implants that they had. Your are not alone! The easiest way to determine what type of implant you had is to request a copy of the operative report from either the hospital, surgery center or your surgeon's office. The implant specifics are recorded on this document. Your office record also includes this information. If it has been over ten years since your procedure, sometimes these records are no longer available. Ultrasound or MRI can help to answer this question but it is an expensive way to solve the mystery and not an indication for these procedures. If you registered your implants with the manufacturer at the time of surgery, the company will have a record of this information. Fortunately, this inforation is not absoltely critical to your health unless you are having a problem with your implants. Your surgeon can often develop a reasonable treatment plan even without this information. I would strongly recommend that you register your implants and purchase the affordable insurance program if you have surgery again. These programs are helpful in storing vital information regarding your implant type, size, filler, model and lot number. Should there be a recall or long term problem requiring additional surgery, this information is readily available. There is often also some fiancial support to offset costs. Investigate the options available by contacting your surgeon or the implant manufacturer's websites.
There are two types of breast implants approved by the Food and Drug Administration (FDA): silicone-filled and saline-filled. They come in various sizes and shapes, and with two types of shells: textured shells and smooth shells. A type of silicone-filled implant with a thicker filling, called a form-stable highly cohesive implant, or "gummy bear" breast implant, is currently under investigation and may one day provide another option for women undergoing breast augmentation with implants.
For women who experience breast sagging, I would recommend a breast lift; not breast reduction surgery. Breast reduction can provide a more modest breast size by removing tissue and skin from the breasts; however, a breast lift is needed to achieve a perkier, higher-positioned breast contour. It’s very common for patients to combine their breast reduction surgery with a breast lift to achieve more comprehensive breast enhancement results.
Another option is to consider getting your breast implants at a teaching hospital from a learning resident. You won’t get the delicate skill of an experienced, board-certified surgeon, but teaching hospital residents are “assisted by established, experienced, private attending surgeons,” says Beverly Hills plastic surgeon Dr. Robin T.W. Yuan in a RealSelf Q&A.