Case 69: This patient was bothered by his prominent ears and a sense of width to his nose that made it feel bulky and unrefined in his view. While still preserving his ethnic identity, he was able to achieve a meaningful improvement in nasal balance. Bringing his ears back into the vertical plane helped to make them less noticeable and remove them as a source of focus for him.

Case 43: Rhinoplasty in this pretty professional woman was all about removing the bump she had hated for years and correcting the tip droop and asymmetry that had worsened with age. Relatively small changes here have created a real sense of refinement while maintaining her long, elegant profile. A lower face and neck lift along with facial fat transfer helped to round out the enhancements in her already beautiful appearance.
Great question!  Without seeing you it is difficult to make an accurate assessment.  However as a general rule, the maximum amount of liposuction that can be performed in an outpatient setting, is around 5 liters due to the vast amount of fluid shift.  After filtration of the fluid, blood, devitalized fat cells, and lipids, generally you are left with about 2 liters of mature viable fat for injection.  Which means 1 liter to each side - which is a lot.  Take into account that you will loose anywhere from 20-40% of the volume so now we are at about 600-800cc's that will remain...that is with a maximum of 5 liter of liposuction.  If you have more than 5 liters of fat, then you may need to undergo this procedure a second time in order to harvest more fat for injection.
When you decide to have breast augmentation surgery, part of the preparation will involve discussing the cost with your surgeon. You'll receive an itemized list of the costs associated with your surgery, and you'll have a chance to ask questions if you have them. Your breast augmentation cost can be broken down to include the following fees and items:
Subpectoral (dual plane): the breast implant is emplaced beneath the pectoralis major muscle, after the surgeon releases the inferior muscular attachments, with or without partial dissection of the subglandular plane. Resultantly, the upper pole of the implant is partially beneath the pectoralis major muscle, while the lower pole of the implant is in the subglandular plane. This implantation technique achieves maximal coverage of the upper pole of the implant, whilst allowing the expansion of the implant's lower pole; however, “animation deformity”, the movement of the implants in the subpectoral plane can be excessive for some patients.[79]
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]
From your description, you seem to be a very good candidate for this new technique and should really get the look that you are desiring without implants or any unnecessary visible scars. I would recommend that you search for an ABPS board certified plastic surgeon who is also a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons in your area or an area that you would like to travel to on holiday who offers the Bellesoma technique to discuss your breast reduction and possible results.  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.
Although reviewing before and after photographs is an important element in selecting the right rhinoplasty surgeon, choosing your surgeon solely on the basis of website photos is ill-advised. Indeed, countless disappointed rhinoplasty patients can attest to the deceptive and misleading nature of many rhinoplasty websites. Moreover, viewing online photos is no substitute for the consultation visit, where I can share numerous other before and after photos, many with noses similar in appearance to your own – a far more meaningful comparison. Although I have been slow to incorporate internet marketing into my rhinoplasty practice, the growing number of individuals who look to the internet as their sole source of medical information cannot be overlooked. Consequently, I offer this website as a source of candid information to equip the prospective rhinoplasty patient with accurate information and honest advice.
Case 96: To see how well our results last, see these photos of our patient 8 years after rhinoplasty and facial fat transfer! Her rhinoplasty involved softening her look and removing the convexity on the bridge that made her tip look downturned. Fat transfer under the eyes has stood the test of time and really helped to reduce her under eye hollows to noticeably brighten her appearance.
Each year, hundreds of thousands of women undergo breast implant surgery, a plastic surgery procedure designed to improve the appearance of the breasts. Also called breast augmentation surgery, most women undergo the procedure to enlarge breasts that are naturally small, though some have it to correct disproportionate breasts or repair breast deformities.
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.

Breast implants are not lifetime devices. The longer a woman has implants, the more likely it is that she will need to have surgery to remove or replace them. The most frequent complications and adverse outcomes experienced by breast implant patients include capsular contracture, reoperation, and implant removal (with or without replacement). Other common complications include implant rupture with deflation, wrinkling, asymmetry, scarring, pain, and infection. In addition, women with breast implants may have a very low but increased likelihood of being diagnosed with anaplastic large cell lymphoma (ALCL).


The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.
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.
1996 France Agence Nationale pour le Developpement de l’Evaluation Medicale (ANDEM) [National Agency for Medical Development and Evaluation][30] French original: "Nous n'avons pas observé de connectivité ni d'autre pathologie auto-immune susceptible d'être directement ou indirectement induite par la présence d'un implant mammaire en particulier en gel de silicone...."
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.
The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.
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]

Firstly about surgical technique. Breast lift and reduction employ similar surgical technique, it's just that with reduction you're removing more breast tissue (because the biggest aim of a reduction is.... to reduce the size of the breast). Does breast lift remove SOME breast tissue, the answer is yes, but the AIM of the lift is more to restore the youthfulness of the breast. Both women, one wanting a reduction vs a lift need their nipple/areolar complex repositioned "up". Only the woman wanting a reduction need the volume addressed.


I never expected such amazing results. The cost and recovery time was completely worth it. My doctor was very honest and informed me that it is pretty much impossible to have perfectly symmetrical breasts. However he proved himself wrong, my breasts are completely even and look as if they have never been touched. He went through my nipples so there is no scarring whatsoever. It was a perfect procedure.


The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.
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.
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.
4. Last but not least, your preference matters a lot!  Before surgery, I ask my patients to bring photos of buttock shapes that they like.  This helps me understand how much of a buttock size increase and shape each patient desires.  Some patients like a more curvy, rounded shape with wide hips (hour-glass figure) while others prefer a more projected or athletic shape.  Your preference of buttock outcome is a very important factor in the decision of how much fat is transferred, so I spend a lot of time with each patient before surgery to understand your goals and express what I think can be achieved.  Good communication between patient and surgeon is very important to achieving optimal surgical outcomes.
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.
In general, silicone-gel-filled implants are smoother, softer and feel more like natural breast tissue than their saline-filled counterparts. Silicone implants feel like a semisolid gel, while saline implants are often likened to water balloons. Silicone-gel implants are also less likely to wrinkle and ripple than saline breast implants. Wrinkling is actually considered one of the major disadvantages of saline implants. The thinner the woman and the less breast tissue she has, the more likely the saline implant's crinkles and wrinkles will be felt and even seen.
While more experienced surgeons may charge more for their expertise, that’s not always the case. “You should not choose a qualified surgeon based on high fees any more than you should choose one based on low fees,” says Boca Raton, Florida plastic surgeon Dr. Hilton Becker in a RealSelf Q&A. “The most important factors should be education, experience, certification, and your ability to feel comfortable with your surgeon.”
Anyone who wants more than a very modest size change will require multiple injection sessions to work up the results – and even then, there is only so much healthy tissue that can be harvested and injected, says Ganchi. (Bony areas typically won’t work as donor sites.) The patient must also have a healthy blood supply to support the healing of living tissue afterwards. 
2009	European Union	International Committee for Quality Assurance, Medical Technologies & Devices in Plastic Surgery panel (IQUAM)	The consensus statement of the Transatlantic Innovations conference (April 2009) indicated that additional medical studies demonstrated no association between silicone gel-filled breast implants and carcinoma, or any metabolic, immune, or allergic disorder.[38]

The procedure is accomplished by using the skin of the lower pole of the breast (the part below the nipple that sits in the bra cup) to shape the whole breast into a perky dome, then straps are made of the extra skin, anchoring it to the underlying chest muscle so that there is virtually no chance of repeat sagging.  The skin that above your nipple and below your collar bone is utilized to cover the perky, lifted dome that has been created and then a new (usually smaller) circular opening for the areola is placed at the high point of the cone, creating your new lifted, full and shapely breast.

The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.
Inframammary: an incision made to the inframammary fold (natural crease under your breast), which affords maximal access for precise dissection of the tissues and emplacement of the breast implants. It is the preferred surgical technique for emplacing silicone-gel implants, because it better exposes the breast tissue–pectoralis muscle interface; yet, IMF implantation can produce thicker, slightly more visible surgical scars.
I felt particularly insecure about my nose when starting college, as I was presenting myself to the world, independently, for the first time. Whenever I met anyone new, I'd be very careful to talk to them only head-on, so they couldn't glimpse my profile. By 19, I was researching rhinoplasty surgery, and my dad even took me for a nose-job consultation, but I didn't feel the surgeon was a good fit, so we decided to table the idea.
Cosmetic surgeons use a variety of incision techniques for breast lift surgery; the exact technique used will vary based on a patient’s existing breast tissue, the amount of excess skin to be removed, and her personal goals. Your cosmetic surgeon will recommend the type of breast lift that will achieve optimal results with the least conspicuous scarring possible. 

In some cases, a breast lift alone may not achieve a patient’s desired results. If you feel your breasts look “deflated” or have lost volume due to aging, weight loss, or pregnancy, your cosmetic surgeon can place breast implants during breast lift surgery to restore fullness and shape to the breast. If you have always wanted larger, lifted breasts, a breast augmentation with lift can help you achieve both with a single procedure and recovery.
“I’ve found that sometimes MRIs are not actually very reliable. In some instances, a patient’s MRI said the silicone gel implant had ruptured, and then when I went in to operate on it, it actually hadn’t. I’ve had one or two patients where an MRI showed the implant wasn’t ruptured, but based on my clinical exam I really thought there was a concern, so I went in and it turned out it was ruptured.”
The ASPS and the Plastic Surgery Foundation (PSF) have partnered with the FDA to study this condition and in doing so created the Patient Registry and Outcomes For breast Implants and anaplastic large cell Lymphoma Etiology and epidemiology (PROFILE). The United States FDA strongly encourages all physicians to report cases to PROFILE in an effort to better understand the role of breast implants in ALCL and the management of this disease.[74]
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