Case 89: This patient had broken her nose with consequent severe loss of tip support, tip rounding, crookedness, and a traumatic bump. In this case, a lateral crural overlay technique was used to reduce and lift the tip along with a septal extension to help with support and straightening which has improved tremendously as seen on the base view. Even though she’s still swollen in these early photos, she already has a great result and it’s only going to get better.
If you’re considering breast lift surgery, choosing a cosmetic surgeon is the most important decision you’ll make. When you visit potential surgeons, ask how frequently he/she performs breast lift surgery and how many total procedures that surgeon has performed. View before and after photos, not just on a surgeon’s website but also during your consultation, paying close attention to the results of patients whose breasts before surgery look similar to yours—this will help you get a feel for a cosmetic surgeon’s aesthetic style.
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. 
Dr. Larry Fan is a Harvard educated, Board Certified Plastic Surgeon in San Francisco, CA. He is a Master Artist who is known for creating beautiful, stunning, and natural results. Dr. Fan has been named One of America's Top Plastic Surgeons for the past 10 years running and has received several national awards for his work in Plastic Surgery. He has successfully performed more than 10,000 cosmetic procedures of the face, breasts, and body over a 20 year period. Dr Fan has been an invited speaker at the American Society of Plastic Surgeons and the American College of Surgeons, and has been featured in national media outlets such as CNN, NBC, and ABC.
We strongly recommend you choose an implant type with your surgeon, who will be able to match the right type to accomplish your desired results. All available implants are considered good, safe choices. However, this article will explain the pros and cons of each of the three main types of breast implants so you can get an idea of what might be the best fit for you.
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.
The amount of good quality, transferrable fat will depend on how much can be retrieved from the donor sites. This can be partially estimated after examination (the surgeon inspects and pinches the areas of potential fat harvest to get an idea of how much fat can realistically be harvested), but it is hard to know for sure until the procedure is well underway. Abdominal and love handle/flank fat tend to be the best sources because the fat is more easily retrieved and softer than back fat, but the back is also routinely liposuctioned in the BBL procedure to both obtain extra tissue for transfer and to improve the 360 degree shaping of the torso. I have transferred anywhere from 300cc per buttock to over 1200 in some patients, depending on the circumstances.
Before surgery, friends and family would say they didn't see anything wrong with my nose, but to have something that's so personal and integral to you feel so wrong...it's exhausting and disheartening. Now I feel not only more beautiful but way more comfortable in my own skin — just like my mom. And now those same friends see the difference and compliment me.
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]
Platinum is a catalyst used in the making of silicone implant polymer shells and other silicone devices used in medicine. The literature indicates that small amounts of platinum leaches (leaks) from these implants and is present in the surrounding tissue. The FDA reviewed the available studies from the medical literature on platinum and breast implants in 2002 and concluded there was little evidence suggesting toxicity from platinum in implant patients.[67] The FDA revisited this study and additional literature several years later, reaffirming prior conclusions that platinum catalysts used in implants is likely not ionized and therefore would not represent a risk to women.[68]
Case 48: This is a good example of finesse rhinoplasty where subtle changes can make for a very nice and meaningful difference. This young woman liked the overall shape of her nose but wanted it slightly smaller in all dimensions to match her pretty, petite features. We were able to achieve these goals by always relying on techniques that produce stable and precise results. Subtle fat transfer to the under eye area further helped to reduce under eye circles and soften her overall look. 

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.
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.
Contoured implants, also called anatomical or teardrop-shaped implants, are shaped like a natural breast and create a sloped shape when placed over the chest muscles. Round breast implants have that, well, "round" Victoria's Secret or Playboy model shape. Contoured implants may flip over if the surgeon does not create the pocket correctly, resulting in a misshapen breast. Not true with round implants. If a round breast implant flips, it still looks the same. Your decision on implant shape should be based on how you want your new breasts to look.

There are a few alternatives to breast augmentation with implants. Fat grafting breast augmentation involves harvesting fat via liposuction from another area of your body and injecting it into your breasts. Fat grafting is typically used to improve the appearance of your breasts after surgery to treat breast cancer, to correct a congenital breast deformity or to even out any imperfections occurring after breast augmentation with implants, such as wrinkles or ripples. The long-term effects of fat grafting to a normal breast are not fully understood, and the degree of augmentation possible via grafting is only modest at best. For these reasons, fat grafting for cosmetic breast augmentation is still considered experimental by many plastic surgeons.

Deciding how much fat to transfer to a patient’s buttocks is a decision made by the surgeon that takes safety, cosmetic result, and patient’s goals into account. I recommend reviewing your goals of surgery, by showing photos, or performing Vectra imaging in office, with your surgeon and listening to their recommendations for the safest, best-looking results possible.


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.
Your surgeon can change the shape of your nasal bones or cartilage in several ways, depending on how much needs to be removed or added, your nose's structure, and available materials. For small changes, the surgeon may use cartilage taken from deeper inside your nose or from your ear. For larger changes, the surgeon can use cartilage from your rib, implants or bone from other parts of your body. After these changes are made, the surgeon places the nose's skin and tissue back and stitches the incisions in your nose.
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]
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 48: This is a good example of finesse rhinoplasty where subtle changes can make for a very nice and meaningful difference. This young woman liked the overall shape of her nose but wanted it slightly smaller in all dimensions to match her pretty, petite features. We were able to achieve these goals by always relying on techniques that produce stable and precise results. Subtle fat transfer to the under eye area further helped to reduce under eye circles and soften her overall look.
Sucking fat from your hips and thighs and injecting it into your boobs or butt may seem like a dream come true—and for some, it is. The process, called fat transfer or fat grafting, involves removing fat from one part of the body via a gentle liposuction, and then injecting it elsewhere. It works well all over the body, but is most commonly used on the face to enhance cheeks, fill hollow lower eyelids, and build up areas that have lost volume due to aging, explains New Jersey plastic surgeon Parham Ganchi, M.D. It’s also commonly used to plump up butts and to increase breast size and improve breast shape.
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.
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 good news is that both types of implants are considered safe. The Food and Drug Administration (FDA) removed silicone implants from the consumer market in 1992 as a precautionary measure after conflicting reports of possible complications surfaced. Some of these complications required breast implant removal. However, silicone gel-filled breast implants were fully exonerated and reapproved in 2006. (Read more about implants and the FDA.)
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. 

My consult with Dr. Kolker set me at ease. We started out talking casually about my nose — what I liked and disliked about it, any relevant medical concerns, that sort of thing. Then he did an evaluation to see if I'd be a candidate for rhinoplasty. He inspected the inside of my nose to check for a deviated septum (all clear). He examined the thickness of my skin, measured the width of my nose, and checked out the tip, all quick and painless.
The woman wanting a lift is usually slightly different. She had breasts she was happy with before, she had loving kids who she may or may not have breastfed, exercised and had a good life. They come wanting to restore the youthful breast they once they had(or better), they hate that it is slightly more deflated than before and it's slightly more south then they'd like. The formal name of this operation is "Mastopexy" and that's why you hear terms like "Mastopexy augmentation" because often in order to restore the youthfulness of the breast you not only need to reposition the nipple/areolar complex "up" with a mastopexy, you also need to provide some additional volume with an implant, hence augmentation as well. The discussion with implant also is entirely different discussion all together, but this highlights the primary difference in the reduction and a lift.

The main advantage of an open surgery, he said, is that it increases exposure of the anatomy for improved visualization, which allows the doctor to be more precise in his surgical maneuvers, and eliminates a key risk associated with the closed rhinoplasty, which is a distortion of the results when instruments are retracted through the nostrils. He believed the open method would be safest and most effective for me since he’d essentially be reworking my entire nose — refining not just the bridge but the tip as well.


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]
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