Hello and thanks for your post and questions. It seems that you would potentially be a fantastic candidate to have a breast reduction and lift using the Bellesoma technique with NO vertical scar! With this technique you should be able to reach a smaller,  but perky and proportional breast size that fits your frame along with achieving upper pole fullness. You've provided great information - the only thing that would be more helpful in order to give you the best advice about your options would be an in-person exam.

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.
Larger areas of the body like the breasts and butt end up being two separate procedures—a full liposuction and a full fat injection—and as such, will typically end up costing more. According to RealSelf.com, the national average cost of a breast fat transfer is $6,525, while the national average cost of a buttock fat transfer is $8,625. The average cost of a traditional implant breast augmentation is $6,300, according to RealSelf.com.
the third technological development was the double lumen breast implant device, a double-cavity prosthesis composed of a silicone breast implant contained within a saline breast implant. The two-fold, technical goal was: (i) the cosmetic benefits of silicone-gel (the inner lumen) enclosed in saline solution (the outer lumen); (ii) a breast implant device the volume of which is post-operatively adjustable. Nevertheless, the more complex design of the double-lumen breast implant suffered a device-failure rate greater than that of single-lumen breast implants. The contemporary versions of second-generation breast implant devices (presented in 1984) are the "Becker Expandable" models of breast implant, which are primarily used for breast reconstruction.
Since the early 1990s, a number of independent systemic comprehensive reviews have examined studies concerning links between silicone gel breast implants and claims of systemic diseases. The consensus of these reviews (outlined below under Safety of Breast Implants heading) is that there has been no evidence of a causal link between the implantation of saline or silicone breast implants and systemic disease After investigating this issue, the U.S. FDA has concurred and since reaffirmed that “the weight of the epidemiological evidence published in the literature does not support an association between fibromyalgia and breast implants.”. A comprehensive systemic review by Lipworth (2011) [66] concludes that "any claims that remain regarding an association between cosmetic breast implants and CTDs are not supported by the scientific literature".
They are essentially very similar procedures. The difference is in the amount of breast tissue removed. In a breast lift procedure, the nipple areolar complex is lift to a better position on the breast, and some breast tissue is removed and the breast envelope tightened. In a breast reduction, the nipple areolar complex is also lifted, but much more breast tissue is removed. 
Dr. Mess receive patients from many for Washington DC and nearby cities and performs the fat transfer in her office in Columbia, Md, at Northwest Hospital near Baltimore, and at Howard County General Hospital. There are different techniques for fat transfer depending on the area being treated; small volume to face and hands vs. medium volume to enhance breast reconstruction vs. large volume to enhance buttocks and augment breast without implants. Common donor sites are the patient’s abdomen, thighs, or love handles.  The fat is suctioned by hand for small volume and by liposuction machine for large volume.  The fat is gently separated to concentrate the viable fat from fluid and nonessential matter.  The concentrated fat is re-injected into the desired area with small cannulas designed to maximize the survival of the transferred fat.  Dr. Sarah Mess has spent years refining her fat transfer technique to offer her patients outstanding fat transfer outcomes.
The first step in the breast implant surgery process is a consultation with a board-certified plastic surgeon who has extensive experience performing various types of breast surgery. During this meeting, the surgeon will perform an examination of your breast tissue, discuss your goals for surgery and tell you what you need to know about breast implants. Based on his or her examination, the surgeon will determine whether you are a candidate for surgery.
Breast reduction surgery will take about two to five hours, sometimes longer. Your surgeon will make a cut around your nipple then downward on the breast in the form of a keyhole. The operating team will remove extra skin, tissue, and fat from your breasts and reposition your nipple. Your surgeon may use drainage tubes and then stitch up your breasts and wrap them in a special gauze. You may also need to wear a surgical bra.
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.
During your consultation, your surgeon will ask about your habits, including whether or not you smoke and what medications you take. You may have to quit smoking for a period before and after surgery to ensure proper healing. You also may have to stop taking certain medications, such as aspirin or other anti-inflammatory drugs such as Motrin or Aleve. Your surgeon will give you instructions about what you need to do.
How much do breast implants cost? That may seem like a simple question, but like many simple questions there are nuances to it. Primary breast augmentations vary based on location, surgeon, and implant you choose. The cost of a breast augmentation and any subsequent breast procedure is typically not covered by insurance companies because it is an elective, cosmetic procedure. Web MD states that the total cost for a breast augmentation surgery can range from $5,000-$10,000. According to statistics from the American Society of Plastic Surgeons in 2017 the average cost of a breast augmentation was $3,718, however this estimate does not include things like anesthesia and other unavoidable surgical expenses. In 2017 the American Society for Aesthetic Plastic Surgery found the average surgeon fees for a breast augmentation with saline implants was $3,515. For silicone gel breast implants it rises to $4,014. Again, these average prices do not include the related medical expenses.
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.
My roommate, Kelsi, who's also my childhood best friend, came with me to Dr. Kolker's office. After a few final checks, Dr. Kolker took more pictures, then marked up my nose. He said people generally puff up under anesthesia, and things can get distorted, so this, in his words, "helps keep him honest." A nurse led me into the OR, and the last thing I remember before going under was this feeling of deep gratitude and thanking everyone there for playing a part in helping me feel better about myself.

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.


Fat Transfer for a Natural Breast Augmentation will use the fat from another area on your body to create a modestly larger breast size. This can be used at the same time as fat grafting to reshape the breasts, as well as a breast lift. Many women choose to go with the fat transfer because they are not introducing any foreign substance to their body.
Case 31: This patient had some typical concerns of feeling washed out from the front with flattening and spreading of her tip. She was very happy with the narrowing and definition achieved for her bridge and tip along with nostril reduction. In addition, chin augmentation increased chin projection to improve the balance of her lower face and jawline.

Dr. Mess typically harvests fat from the abdomen through a tiny incision in the belly button using state-of-the-art cannulas specifically designed to create small particle size for greater accuracy and for maximal fat cell viability. If the patient does not have adequate abdominal fat she may harvest from the thighs, love handles or other sites. The fat will be placed in a centrifuge where the fat will be separated from fluids and non-essential elements. The fat will then be transferred to the recipient site using precisely placed injections on multiple plains to achieve the structure and look you desire. On the day of the procedure, donor and graft sites will be laid out and marked following the plan designed during your consultation.  Dr. Mess uses markers to map the surgery and distinguish between donor and recipient sites.
When talking about the price with your plastic surgeon, it’s important to know exactly what the cost covers. Is it just the surgeon’s fee? Or will it cover anesthesia, facility fees, implant cost, medical tests, pre- or post-op appointments, and medical supplies you’ll need during recovery? Do you need to purchase a specific bra for recovery or will they provide one?
Both saline-filled breast implants and silicone-filled implants have an outer shell composed of silicone elastomer. This shell is basically a flexible envelope that contains the implant filling. In the case of some anatomically shaped implants, the shell also gives the implants shape. Some models of implants have a "double lumen." This is an elastomer envelope inside of another elastomer envelope (sort of like double-bagging your groceries) which may reduce the risk of implant rupture.
Dr. Cohen specializes in breast lifts, augmentations, revisions and reductions as well as breast cancer reconstructions. A long time dream of Dr. Cohen’s was to travel to developing countries and provide expert surgical care to those who have no other possible access to medical care. This became a reality in 2007 when she became a founding member and Vice President of ISMS Operation Kids.
Case 39: The facial plastic surgeons at PROFILES Beverly Hills tailor every Rhinoplasty to achieve just what you are looking for. Sometimes, the most subtle of changes take just as much effort as the most dramatic ones. This pretty model didn’t want to drastically change her look. Her Los Angeles Finesse Rhinoplasty gave her the refinement she wanted, especially on her front and three-quarter views. Along with fat transfer to the lower eye area, her overall look was softened to make her that much more camera ready.
Furthermore, The Effect of Study design Biases on the Diagnostic Accuracy of Magnetic Resonance Imaging for Detecting Silicone Breast Implant Ruptures: a Meta-analysis (2011) reported that the breast-screening MRIs of asymptomatic women might overestimate the incidence of breast implant rupture.[53] In the event, the U.S. Food and Drug Administration emphasised that “breast implants are not lifetime devices. The longer a woman has silicone gel-filled breast implants, the more likely she is to experience complications.”[54]
2000 European Union European Committee on Quality Assurance & Medical Devices in Plastic Surgery (EQUAM) "Additional medical studies have not demonstrated any association between silicone-gel filled breast implants and traditional auto-immune or connective tissue diseases, cancer, nor any other malignant disease. . . . EQUAM continues to believe that there is no scientific evidence that silicone allergy, silicone intoxication, atypical disease or a 'new silicone disease' exists."[34]
2. You buttock's structural anatomy is also an important factor.  A V-shaped buttock typically requires more fat transfer to achieve a satisfactory improvement than an A-shaped buttock.  Transferred fat cells need to grow their own blood supply from the surrounding buttock tissues in order to survive.  In order for this to happen, the transferred fat cells need to be gently interwoven between your buttocks' living cells to survive.  Therefore, each person's buttocks can only receive a certain amount of fat, and exceeding that amount will not be effective.  A generous amount of fat is typically transferred at the time of surgery, knowing that some of the fat will go away during the recovery period.
In 2006, for the Inamed Corporation and for the Mentor Corporation, the U.S. Food and Drug Administration lifted its restrictions against using silicone-gel breast implants for breast reconstruction and for augmentation mammoplasty. Yet, the approval was conditional upon accepting FDA monitoring, the completion of 10-year-mark studies of the women who already had the breast implants, and the completion of a second, 10-year-mark study of the safety of the breast implants in 40,000 other women.[119] The FDA warned the public that breast implants do carry medical risks, and recommended that women who undergo breast augmentation should periodically undergo MRI examinations to screen for signs of either shell rupture or of filler leakage, or both conditions; and ordered that breast surgery patients be provided with detailed, informational brochures explaining the medical risks of using silicone-gel breast implants.[113]

I had wrongly assumed he could simply flatten the hump and be done, but he explained that you can't sculpt one area without considering how it'll impact everything else. If he smoothed the bridge and did nothing else, my nose could wind up looking far too wide from the front. So ultimately, he would need to break my nose and seamlessly draw it in closer to create the precise size and shape I was after. He'd also have to reduce the cartilage at the tip and turn it up slightly, from 91 to 93 degrees. In the end, my nose would be smaller, with a straighter bridge, a refined tip, and more clearly defined nostrils.
×