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.
Dr. Mess typically harvests fat from the abdomen through a tiny incision in the belly button using state-of-the-art cannulas specifically designed to create small particle size for greater accuracy and for maximal fat cell viability. If the patient does not have adequate abdominal fat she may harvest from the thighs, love handles or other sites. The fat will be placed in a centrifuge where the fat will be separated from fluids and non-essential elements. The fat will then be transferred to the recipient site using precisely placed injections on multiple plains to achieve the structure and look you desire. On the day of the procedure, donor and graft sites will be laid out and marked following the plan designed during your consultation.  Dr. Mess uses markers to map the surgery and distinguish between donor and recipient sites.
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.
Case 42: Crooked noses can be one of the hardest things to correct in Rhinoplasty, especially if there has been significant trauma involved. The entire nose must be reconstructed in order to make the desired improvements. It took a lot of work to straighten and improve breathing in this patient’s nose. At the same time, his Beverly Hills Rhinoplasty was designed to make his nose a little smaller, more refined, and less down-turned while still looking natural. Even the scar on his tip was improved as part of his surgery.
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.
In 1999, the Institute of Medicine published the Safety of Silicone Breast Implants (1999) study that reported no evidence that saline-filled and silicone-gel filled breast implant devices caused systemic health problems; that their use posed no new health or safety risks; and that local complications are “the primary safety issue with silicone breast implants”, in distinguishing among routine and local medical complications and systemic health concerns.”[113][114][115]
Dr. Rotemberg will examine the area of your body you would like to improve upon for muscle strength, skin elasticity, and fat loss, as well as the area in which she believes the fat should be transferred from. At this time, she will also ask you pertinent medical questions, and do a full exam, to make sure you are a good candidate for any procedure.

The fat transfer procedure is fairly similar for all areas of the body, by taking fat from one area of your body, usually your stomach, buttocks, or thighs, through Liposuction, and then transferring it to a desired area. You will not only gain in one area, but lose in another area that you would like to. While the procedure is basically the same for all, the information below will explain how each area will show improvement.

A breast lift involves both repositioning the nipple higher on the chest wall and reshaping the breast.  A breast reduction does the same but also removes breast tissue to make the breasts smaller.  If you are considering a breast reduction with lift or breast lift alone, I would recommend an in-person consultation with a plastic surgeon to allow for a thorough physical examination and a detailed discussion regarding your options to determine the best treatment plan for you.  Best of luck!

Saline-filled Breast Implants. Saline-filled breast implants are filled with sterile saline (salt water). They come in both smooth and textured shells and can be round or anatomically (tear-drop) shaped. Saline breast implants are also available in low and high profiles, and in many sizes. A saline-filled breast implant is usually empty before implantation. The doctor moves it into place during your surgery, and then fills it. The saline is administered via a process that ensures the implants remain sterile.
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.

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 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]
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.
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.
Hello and thanks for your post and questions. It seems that you would potentially be a fantastic candidate to have a breast reduction and lift using the Bellesoma technique with NO vertical scar! With this technique you should be able to reach a smaller,  but perky and proportional breast size that fits your frame along with achieving upper pole fullness. 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.
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.
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 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).

Saline breast implants are filled with sterile saltwater. This implant type is recommended for women who do not wish to have silicone implants as well as some women who desire the 'Baywatch' look with a high degree of upper pole fullness and projection. In the right patient, saline implants can also look very natural. Saline implants are generally less popular today than silicone implants.
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.

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.
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. 
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.

I had wrongly assumed he could simply flatten the hump and be done, but he explained that you can't sculpt one area without considering how it'll impact everything else. If he smoothed the bridge and did nothing else, my nose could wind up looking far too wide from the front. So ultimately, he would need to break my nose and seamlessly draw it in closer to create the precise size and shape I was after. He'd also have to reduce the cartilage at the tip and turn it up slightly, from 91 to 93 degrees. In the end, my nose would be smaller, with a straighter bridge, a refined tip, and more clearly defined nostrils.
The FDA has identified that breast implants may be associated with a rare form of cancer called anaplastic large-cell lymphoma, believed to be associated with chronic bacterial inflammation.[69] Similar ALCL phenomena have been seen with other types of medical implants including vascular access ports, orthopedic hip implants, and jaw (TMJ) implants. As of February 1, 2017, the FDA has received a total of 359 medical device reports of breast-implant-associated ALCL (BIALCL), including 9 deaths.[70] Most cases of breast implant-associated ALCL had implants in for many years prior to the condition, and are usually treated successfully by simple removal of the implant and the capsule surrounding the implant without the need for chemotherapy if no evidence of systemic disease exists. If women with implants present with delayed swelling or fluid collection, cytologic studies and test for a marker "CD30" are suggested. The American Society of Plastic Surgery (ASPS) states, "CD30 is the main diagnostic test that must be performed on the seroma fluid as routine pathology or H&E staining can frequently miss the diagnosis." [71] Diagnosis and treatment of breast implant associated ALCL now follows standardized guidelines established by the National Comprehensive Cancer Network.[72]
This includes the cost of the implants, which ranges from $1,000 to $1,300 as well as a facility fee of $800 to $1,200, an anesthesia fee of $600 to $800 and the surgeon's fee that averages $4,005 for silicone-gel filled implants and $3,583 for saline implants. Patients in the western United States can expect to pay the highest average surgeon's fee of about $3,949, while patients in the south central part of the country generally pay lower fees with an average of $2,739.
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.
The breast cancer studies Cancer in the Augmented Breast: Diagnosis and Prognosis (1993) and Breast Cancer after Augmentation Mammoplasty (2001) of women with breast implant prostheses reported no significant differences in disease-stage at the time of the diagnosis of cancer; prognoses are similar in both groups of women, with augmented patients at a lower risk for subsequent cancer recurrence or death.[103][104] Conversely, 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] That patients with breast implants are more often diagnosed with palpable—but not larger—tumors indicates that equal-sized tumors might be more readily palpated in augmented patients, which might compensate for the impaired mammogram images.[106] The ready palpability of the breast-cancer tumor(s) is consequent to breast tissue thinning by compression, innately in smaller breasts a priori (because they have lesser tissue volumes), and that the implant serves as a radio-opaque base against which a cancerous tumor can be differentiated.[107]

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.”

Prepectoral or subcutaneous: in a breast reconstruction following a skin-sparing or skin- and nipple-sparing mastectomy, the implant is placed above the pectoralis major muscle without dissecting it so that the implant fills directly the volume of the mammary gland that has been removed. To avoid the issue of capsular contracture, the implant is often covered frontally or completely with a mesh in biomaterial, either biological or synthetic.
Subfascial: the breast implant is emplaced beneath the fascia of the pectoralis major muscle; the subfascial position is a variant of the subglandular position for the breast implant.[77] The technical advantages of the subfascial implant-pocket technique are debated; proponent surgeons report that the layer of fascial tissue provides greater implant coverage and better sustains its position.[78]
In the mid-twentieth century, Morton I. Berson, in 1945, and Jacques Maliniac, in 1950, each performed flap-based breast augmentations by rotating the patient's chest wall tissue into the breast to increase its volume. Furthermore, throughout the 1950s and the 1960s, plastic surgeons used synthetic fillers—including silicone injections received by some 50,000 women, from which developed silicone granulomas and breast hardening that required treatment by mastectomy.[112] In 1961, the American plastic surgeons Thomas Cronin and Frank Gerow, and the Dow Corning Corporation, developed the first silicone breast prosthesis, filled with silicone gel; in due course, the first augmentation mammoplasty was performed in 1962 using the Cronin–Gerow Implant, prosthesis model 1963. In 1964, the French company Laboratoires Arion developed and manufactured the saline breast implant, filled with saline solution, and then introduced for use as a medical device in 1964.[88]

Once we set a date for surgery, Dr. Kolker prescribed various vitamins (C, B12, and zinc) to start taking one week prior to surgery to prep my body for the trauma and help speed recovery. I'd have to avoid red wine and blood thinners (like Advil) for two weeks beforehand. He prescribed pain medication, too, but said I may only need Tylenol post-op because the discomfort isn't all that bad. There would be lots of bruising and swelling, but after six weeks, he said, my appearance should be back to normal, only with a better nose. After three months, I'd be 75 percent healed, but the swelling wouldn't fully subside for one year.


No. Rhinoplasty is a challenging operation. This is due to several factors. First, the nose is a complicated 3D shape that is in the middle of the face. Changes made during rhinoplasty are often very small. But these changes can make a major difference in the way the nose looks and functions. Because these changes are small, so is the margin for error.
A discussion of your expectations. You and your doctor should talk about your motivations and expectations. He or she will explain what rhinoplasty can and can't do for you and what your results might be. It's normal to feel a little self-conscious discussing your appearance, but it's very important that you're open with your surgeon about your desires and goals for surgery.
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...."

In 2000, the FDA approved saline breast implant Premarket Approval Applications (PMA) containing the type and rate data of the local medical complications experienced by the breast surgery patients.[116] "Despite complications experienced by some women, the majority of those women still in the Inamed Corporation and Mentor Corporation studies, after three years, reported being satisfied with their implants."[113] The premarket approvals were granted for breast augmentation, for women at least 18 years old, and for women requiring breast reconstruction.[117][118]
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.

In 1988, twenty-six years after the 1962 introduction of breast implants filled with silicone gel, the U.S. Food and Drug Administration (FDA) investigated breast implant failures and the subsequent complications, and re-classified breast implant devices as Class III medical devices, and required from manufacturers the documentary data substantiating the safety and efficacy of their breast implant devices.[113] In 1992, the FDA placed silicone-gel breast implants in moratorium in the U.S., because there was “inadequate information to demonstrate that breast implants were safe and effective”. Nonetheless, medical access to silicone-gel breast implant devices continued for clinical studies of post-mastectomy breast reconstruction, the correction of congenital deformities, and the replacement of ruptured silicone-gel implants. The FDA required from the manufacturers the clinical trial data, and permitted their providing breast implants to the breast augmentation patients for the statistical studies required by the U.S. Food and Drug Administration.[113] In mid–1992, the FDA approved an adjunct study protocol for silicone-gel filled implants for breast reconstruction patients, and for revision-surgery patients. Also in 1992, the Dow Corning Corporation, a silicone products and breast implant manufacturer, announced the discontinuation of five implant-grade silicones, but would continue producing 45 other, medical-grade, silicone materials—three years later, in 1995, the Dow Corning Corporation went bankrupt when it faced large class action lawsuits claiming a variety of illnesses.[113]

In 2006, for the Inamed Corporation and for the Mentor Corporation, the U.S. Food and Drug Administration lifted its restrictions against using silicone-gel breast implants for breast reconstruction and for augmentation mammoplasty. Yet, the approval was conditional upon accepting FDA monitoring, the completion of 10-year-mark studies of the women who already had the breast implants, and the completion of a second, 10-year-mark study of the safety of the breast implants in 40,000 other women.[119] The FDA warned the public that breast implants do carry medical risks, and recommended that women who undergo breast augmentation should periodically undergo MRI examinations to screen for signs of either shell rupture or of filler leakage, or both conditions; and ordered that breast surgery patients be provided with detailed, informational brochures explaining the medical risks of using silicone-gel breast implants.[113]
I had wrongly assumed he could simply flatten the hump and be done, but he explained that you can't sculpt one area without considering how it'll impact everything else. If he smoothed the bridge and did nothing else, my nose could wind up looking far too wide from the front. So ultimately, he would need to break my nose and seamlessly draw it in closer to create the precise size and shape I was after. He'd also have to reduce the cartilage at the tip and turn it up slightly, from 91 to 93 degrees. In the end, my nose would be smaller, with a straighter bridge, a refined tip, and more clearly defined nostrils.
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