Case 37: Achieving a beautiful, natural change in an already beautiful woman is one of the great challenges we love in rhinoplasty. In front view you see a beautifully defined, natural change that simply looks great. Then on profile and 3/4 views, you see an elegant change where the tip is deprojected (made smaller) but retains a beautiful, natural aesthetic- this is finesse rhinoplasty.
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 38: This beautiful young lady is an early 6 month example of a finesse rhinoplasty. On front view you can see the bridge is narrower and the sense of hang is improved. On profile, the tip looks undone, natural and less projected with correction of the slight hanging columella. The result is a beautiful, natural look that corrects the issues but leaves her looking totally natural and undone.
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.
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.
By the next day, I was looking more like a monster and didn't want to see anyone. The bruises around my eyes shined a bright greenish-purple, and I was swollen all over with some intense pressure in my head. I couldn't breathe through my nose anymore, because of all the blood and swelling. I felt congested and uncomfortable, almost like I had a bad cold, but again, nothing Tylenol couldn't handle. But I fully expected this, as Dr. Kolker said it could take two weeks for everything to run its course.
Very slight changes to the structure of your nose — often measured in millimeters — can make a large difference in how your nose looks. Most of the time, an experienced surgeon can get results both of you are satisfied with. But in some cases, the slight changes aren't enough, and you and your surgeon might decide to do a second surgery for further changes. If this is the case, you must wait at least a year for the follow-up surgery, because your nose can go through changes during this time.

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. 


Because you’re injecting your body with something produced by your body, some people consider it “natural” plastic surgery, and it’s increasing in popularity. Breast augmentation using fat transfer increased 72 percent in 2016 while buttock augmentation using fat transfer increased by 26 percent, according to the American Society of Plastic Surgeons.
Case 46: A hump and hanging tip cause the nose to dominate otherwise beautiful features in this young woman. In this case, a tip lift, hump reduction, and tip refinement preserves some of her rounded appearance, very naturally enhancing her pretty eyes. On the bottom view, we see a good example of how open rhinoplasty incisions should heal virtually undetectably when done with care.
Case 29: Major concerns for this patient were widening of the tip with a marked lack of projection which made his nose feel flat and washed out. Nostril thickness and rounding was also something he wanted addressed. In this case, irradiated donor rib cartilage was used to project and support the tip along with alar base reduction removing a significant amount of nostril flare to create a natural tip and nostril contour that is ethnically appropriate. Fat transfer to the cheeks helps to balance out his flat mid-face to strengthen the cheek contour which can be seen nicely on the profile view.
The current lifetime risk of BIA-ALCL in the U.S. is unknown, but estimates have ranged between estimated to be between 1 in 70,000 to 1 in 500,000 women with breast implants according to MD Anderson.[73] Certain geographic locations have demonstrated variable risks. For instance, a December 2016 update from the Therapeutic Goods Administration of Australia and New Zealand reported a risk of 1:1,000 to 1:10,000 for textured implants.".[71] To date (2017), there has not been a case of BIAL reported where the patient had only implantation of smooth shell breast implants or a textured tissue expander that was exchanged for a smooth implant. The paucity of cases reported in Asian populations has raised the possibility that there may be a range of genetic susceptibility to the phenomena, or alternatively merely reflect differences in how cases are identified and reported.
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