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.
After reviewing the medical data, the U.S. Food and Drug Administration concluded that TDA-induced breast cancer was an infinitesimal health-risk to women with breast implants, and did not justify legally requiring physicians to explain the matter to their patients. In the event, polyurethane-coated breast implants remain in plastic surgery practice in Europe and in South America; and no manufacturer has sought FDA approval for medical sales of such breast implants in the U.S.[93]
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.
Breast augmentation: If you desire a modest increase in breast size, you are a good candidate for fat grafting to the breast, but your breasts should already have a nice shape and good skin tone. If you have poor skin, sagging breasts, or want a significant increase in breast size, breast augmentation with fat transfer is not for you. The problem with only using fat for breast enhancement lies in getting large volumes of fat to predictably “take.”

Your medical history. The most important question your doctor will ask you is about your motivation for surgery and your goals. Your doctor will also ask questions about your medical history — including a history of nasal obstruction, surgeries and any medications you take. If you have a bleeding disorder, such as hemophilia, you may not be a candidate for rhinoplasty.
The saline breast implant—filled with saline solution (biological-concentration salt water 0.90% w/v of NaCl, ca. 300 mOsm/L.)—was first manufactured by the Laboratoires Arion company, in France, and was introduced for use as a prosthetic medical device in 1964. The contemporary models of saline breast implant are manufactured with thicker, room-temperature vulcanized (RTV) shells made of a silicone elastomer. The study In vitro Deflation of Pre-filled Saline Breast Implants (2006) reported that the rates of deflation (filler leakage) of the pre-filled saline breast implant made it a second-choice prosthesis for corrective breast surgery.[88] Nonetheless, in the 1990s, the saline breast implant was the prosthesis most common device used for breast augmentation surgery in the United States, because of the U.S. FDA's restriction against the implantation of silicone-filled breast implants outside of clinical studies. Saline breast implants have enjoyed little popularity in the rest of the world, possessing negligible market share.
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.
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.
the second technological development was a polyurethane foam coating for the shell of the breast implant; the coating reduced the incidence of capsular contracture, by causing an inflammatory reaction that impeded the formation of a capsule of fibrous collagen tissue around the breast implant. Nevertheless, despite that prophylactic measure, the medical use of polyurethane-coated breast implants was briefly discontinued, because of the potential health-risk posed by 2,4-toluenediamine (TDA), a carcinogenic by-product of the chemical breakdown of the polyurethane foam coating of the breast implant.[92]
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.

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. 

Potential candidates should also have adequate fat reserves for transfer. This becomes especially important when one considers the anticipated rate of fat resorption and graft loss. I typically recommened patients aim for at least 500 cc transferred per cheek. This would amount to 1 liter of fat (not lipoaspirate) after processing. Candidates with inadequate fat reserves are likely to be disappointed with their ultimate volume once healing is complete. 
I have had much experience in fat grafting to the buttocks for Brazillian Buttock Augmentation in Los Angeles. I have had patients from 105 lbs to more than 200 lbs. the best results were in those that had much fat available for harvesting. In my experience depending on the technique of harvesting, processing, and injecting the fat, at least 90% of the volume can stay. I have had several patients who have retained more than 90% of their buttock volume despite having had pregnacies, working out, and after more than 5 years.

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.
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.
The cause of capsular contracture is unknown, but the common incidence factors include bacterial contamination, device-shell rupture, filler leakage, and hematoma. The surgical implantation procedures that have reduced the incidence of capsular contracture include submuscular emplacement, the use of breast implants with a textured surface (polyurethane-coated);[55][56][57] limited pre-operative handling of the implants, limited contact with the chest skin of the implant pocket before the emplacement of the breast implant, and irrigation of the recipient site with triple-antibiotic solutions.[58][59]

In 1998, the U.S. FDA approved adjunct study protocols for silicone-gel filled implants only for breast reconstruction patients and for revision-surgery patients; and also approved the Dow Corning Corporation's Investigational Device Exemption (IDE) study for silicone-gel breast implants for a limited number of breast augmentation-, reconstruction-, and revision-surgery patients.[113]
Bellesoma is a new breast reduction and lift technique that seems like it would be a great fit for you.  This procedure utilizes 3-D volumetric scanning and a multi-point measuring system to design a precise surgical blueprint exactly tailored to your body and the reduced breast size that you desire. The Bellesoma procedure reduces the sagging and weight of your breast, lifts your breast and reduces areola diameter, preserves the nipple sensation and ability to breast feed.  After Bellesoma, your breasts will look as full and perky as if an implant had been placed without using any implant, so no need to compromise.  One of the huge positives of this technique is that there is NO vertical incision traveling down the front of your breasts.
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.
Case 60: Facial aging can be hard on someone who is naturally thin by creating a more severe and skeletonized appearance as facial fat is lost. A combined approach was used to create a beautiful transformation, including a trichophytic brow lift, lower lid tightening, and facelift along with a conservative rhinoplasty to straighten and balance her nose. Notice how the eyes are opened up and facial hollows are smoothened without the surprised look that can accompany over-aggressive lifts. You’ll also see that incisions are hidden within the hairline and natural skin creases making them almost invisible.
The ideal candidate is in search of relatively small enhancement to her breasts, has natural lift with good bust contour, and has excess body fat to remove, says Few. In reality, most women are seeking much more of a size increase and change in shape and lift than fat transfer can currently offer. And if you have a history of breast cancer in your family, it’s not recommended you get fat transfer, as the injected cells can get in the way of certain breast cancer screenings, says Few. 
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.
The saline breast implant—filled with saline solution (biological-concentration salt water 0.90% w/v of NaCl, ca. 300 mOsm/L.)—was first manufactured by the Laboratoires Arion company, in France, and was introduced for use as a prosthetic medical device in 1964. The contemporary models of saline breast implant are manufactured with thicker, room-temperature vulcanized (RTV) shells made of a silicone elastomer. The study In vitro Deflation of Pre-filled Saline Breast Implants (2006) reported that the rates of deflation (filler leakage) of the pre-filled saline breast implant made it a second-choice prosthesis for corrective breast surgery.[88] Nonetheless, in the 1990s, the saline breast implant was the prosthesis most common device used for breast augmentation surgery in the United States, because of the U.S. FDA's restriction against the implantation of silicone-filled breast implants outside of clinical studies. Saline breast implants have enjoyed little popularity in the rest of the world, possessing negligible market share.
MENTOR® MemoryGel® Breast Implants, MENTOR® MemoryShape® Breast Implants, and MENTOR® Saline-filled Breast Implants are indicated for breast augmentation in women (at least 22 years old for MemoryGel® Implants and MemoryShape® Implants, and 18 years old for Saline Implants) or for breast reconstruction. Breast implant surgery should not be performed in women with active infection anywhere in their body, with existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions, or who are currently pregnant or nursing.
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.
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.

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.
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