Case 40: Excessive nasal width can cause the nose to dominate other fine, delicate facial features. In Ethnic Rhinoplasty, the key to obtaining a more refined nose is to create a nasal framework upon which the thick skin will wrap around. This pretty young Persian woman wanted to reduce her nasal width, the fullness in her tip, and the sense that her tip was downturned. These six month photos show significant improvements in achieving these goals and her nose will only get better yet.
We may eat right, exercise, try to keep stress at a minimum, and get a good night’s sleep most nights, but this does not stop all the changes in our bodies. These changes can frustrate us and make us think our efforts are in vain, as well as deflate our features and our self-esteem. One way of enhancing our bodies and our self-esteem is to create fuller features that have lost their youthfulness. If this is the case, fat transfer might be a good option for you.
Periareolar: a border-line incision along the periphery of the areola, which provides an optimal approach when adjustments to the IMF position are required, or when a mastopexy (breast lift) is included to the primary mammoplasty procedure. In periareolar emplacement, the incision is around the medial-half (inferior half) of the areola's circumference. Silicone gel implants can be difficult to emplace via periareolar incision, because of the short, five-centimetre length (~ 5.0 cm) of the required access-incision. Aesthetically, because the scars are at the areola's border (periphery), they usually are less visible than the IMF-incision scars of women with light-pigment areolae; when compared to cutaneous-incision scars, the modified epithelia of the areolae are less prone to (raised) hypertrophic scars.
There are two main types of implants for you to consider: saline and silicone. Most people say the silicone implants feel and look more natural than saline, but they cost more. Silicone implants are typically about $1,000 more than saline, but if you’re interested in gummy bear implants—a type of silicone implant—expect to pay even more. In a RealSelf Q&A, Omaha, Nebraska plastic surgeon Dr. Richard J. Bruneteau says you should expect to pay “about $500 more than standard silicone implants.”
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.
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.
Functional breast-feeding difficulties arise if the surgeon cut the milk ducts or the major nerves innervating the breast, or if the milk glands were otherwise damaged. Milk duct and nerve damage are more common if the incisions cut tissue near the nipple. The milk glands are most likely to be affected by subglandular implants (under the gland), and by large-sized breast implants, which pinch the lactiferous ducts and impede milk flow. Small-sized breast implants, and submuscular implantation, cause fewer breast-function problems; however, it is impossible to predict whether a woman who undergoes breast augmentation will be able to successfully breast feed since some women are able to breast-feed after periareolar incisions and subglandular placement and some are not able to after augmentation using submuscular and other types of surgical incisions.[101]

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.
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