Case 4: Some might think that this patient had had previous rhinoplasty with tip collapse, but she did not. Occasionally, the shape of the tip cartilages is very vertically-oriented, causing a deep groove in the nostril. She felt this, along with her marked tip crookedness, drew unwanted attention to her nose. Now, her nose is smaller, smoother, more defined, and just blends with the rest of her face.

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.

For the first part, even though you did not post photos, based on your height and weight you would have plenty of fat to be able to take in my opinion. The relative limit on how much can be removed and send you home the same day safely is about 5 liters of liposuction/fat. I think you would easily be able to get to this upper limit based on your height and weight.
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.
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.

The cost of compression garments varies. Women who choose smaller implants may find that a sports bra provides plenty of support. The most important thing is to follow your surgeon's recommendations to ensure your breasts get enough support while they heal. Some surgeons will put you in a garment after surgery at no cost and only charge for additional garments. You can learn about what your surgeon does at your consultation.

Fat transfer surgery is a hot topic among today’s elite plastic surgeons. Dr. Mess researched and trained in fat transfer during her six-year residency at Georgetown University Hospital and incorporated the procedure early in her practice. She has refined her technique to offer the advantages of fat transfer to augment and reconstruct. Dr. Mess performs fat transfer to the face, breast, hands, and buttocks to add volume and fullness and restore a youthful and vigorous appearance.


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.
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.
Your surgeon can take photos of your breasts and detail your physical symptoms caused by enlarged breasts in a letter. Get in touch with your health insurer early and make sure you understand exactly what they will pay for. For example, will insurance cover such things as lab costs or anesthesiologist fees? Asking in advance will help prevent surprise costs after the surgery.

In 2008, the longitudinal study Excess Mortality from Suicide and other External Causes of Death Among Women with Cosmetic Breast Implants (2007), reported that women who sought breast implants are almost 3 times as likely to commit suicide as are women who have not sought breast implants. Compared to the standard suicide-rate for women of the general populace, the suicide-rate for women with augmented breasts remained constant until 10-years post-implantation, yet, it increased to 4.5 times greater at the 11-year mark, and so remained until the 19-year mark, when it increased to 6 times greater at 20-years post-implantation. Moreover, additional to the suicide-risk, women with breast implants also faced a trebled death-risk from alcoholism and the abuse of prescription and recreational drugs.[12][13] Although seven studies have statistically connected a woman's breast augmentation to a greater suicide-rate, the research indicates that breast augmentation surgery does not increase the death rate; and that, in the first instance, it is the psychopathologically-inclined woman who is more likely to undergo a breast augmentation procedure.[14][15][16][17][18][19]
Since the early 1990s, a number of independent systemic comprehensive reviews have examined studies concerning links between silicone gel breast implants and claims of systemic diseases. The consensus of these reviews (outlined below under Safety of Breast Implants heading) is that there has been no evidence of a causal link between the implantation of saline or silicone breast implants and systemic disease After investigating this issue, the U.S. FDA has concurred and since reaffirmed that “the weight of the epidemiological evidence published in the literature does not support an association between fibromyalgia and breast implants.”. A comprehensive systemic review by Lipworth (2011) [66] concludes that "any claims that remain regarding an association between cosmetic breast implants and CTDs are not supported by the scientific literature".
Breast lift surgery is typically performed as an outpatient procedure using general anesthesia or local anesthesia + intravenous sedation. The procedure takes about 1-2 hours to perform, depending on the extent of surgery. You will be able to go home shortly after surgery to continue your recovery. Your breasts will be bandaged or placed in a surgical bra.
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.

“How much do breast implants cost” is an important question to ask before starting your breast augmentation journey. If you’re thinking about a breast augmentation, make sure you know the true cost of breast implants, not just the cost of a primary augmentation. Take into consideration the likelihood of complications, the cost of ongoing maintenance, and the anxiety you may feel not knowing the status of your implant. Beautiful, natural looking breast implants with low maintenance and low risk of complications are within your reach. For more information on the IDEAL IMPLANT Structured Breast Implant, including how you can find an IDEAL IMPLANT surgeon near you visit idealimplant.com.
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.
Implants come in various sizes, and your surgeon will guide you on choosing the right size to help you achieve the look you desire. In addition, your surgeon will help you decide whether you want a more natural, teardrop shape or a more rounded look. Implants also come with either smooth our textured shell surfaces, and your surgeon will help you decide which is best for you.
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. 

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.

In the 1980s, the models of the Third and of the Fourth generations of breast implant devices were sequential advances in manufacturing technology, such as elastomer-coated shells that decreased gel-bleed (filler leakage), and a thicker (increased-cohesion) filler gel. Sociologically, the manufacturers of prosthetic breasts then designed and made anatomic models (natural breast) and shaped models (round, tapered) that realistically corresponded with the breast- and body- types of women. The tapered models of breast implant have a uniformly textured surface, which reduces the rotation of the prosthesis within the implant pocket; the round models of breast implant are available in smooth-surface- and textured-surface- types.
Am I happy with my breast size when wearing a bra? A breast lift alone will not significantly change the size of your breasts. It can help your breasts look fuller, rounder, and better in a bra, but if you would like your breasts to be larger or smaller, a breast lift in conjunction with a breast augmentation or reduction may be the right option for you.
Your primary augmentation is not the only cost you need to factor in when you are asking how much do breast implants cost. Women with silicone gel breast implants must factor in long term maintenance costs. Silicone gel breast implants can have “silent ruptures,” where an implant ruptures without showing any symptoms. The FDA recommends women with silicone gel implants get an MRI scan three years after getting their implants, then every two years for the life of the implant to detect silent ruptures. If a silicone gel implant ruptures, you will need surgery to remove the implant shell and any leaked silicone gel. It is important to remove implants that have ruptured because the silicone gel may begin to leak outside of the capsule and cause painful symptoms. The FDA lists a few of these symptoms as, “a decrease in breast size, change in breast implant shape, hard lumps over the implant or chest area, an uneven appearance of the breasts, pain or tenderness, tingling, swelling, numbness, burning, or changes in sensation.” However, because of the out-of-pocket cost of MRIs, many women skip their recommended MRI scans. According to Business Insider the average cost of an MRI is $444 to $1468. That means if a woman with silicone gel breast implants keeps up with the recommended MRIs she will pay on average $3,108 to $10,276 just for MRIs if her implants stay intact for 20 years. That puts the total cost of silicone gel breast implants closer to $10,000-$20,000 over 20 years, and even more if a revision surgery is needed.

Fat transfer surgery is a hot topic among today’s elite plastic surgeons. Dr. Mess researched and trained in fat transfer during her six-year residency at Georgetown University Hospital and incorporated the procedure early in her practice. She has refined her technique to offer the advantages of fat transfer to augment and reconstruct. Dr. Mess performs fat transfer to the face, breast, hands, and buttocks to add volume and fullness and restore a youthful and vigorous appearance.
The study Safety and Effectiveness of Mentor’s MemoryGel Implants at 6 Years (2009), which was a branch study of the U.S. FDA's core clinical trials for primary breast augmentation surgery patients, reported low device-rupture rates of 1.1 per cent at 6-years post-implantation.[49] The first series of MRI evaluations of the silicone breast implants with thick filler-gel reported a device-rupture rate of 1 percent, or less, at the median 6-year device-age.[50] Statistically, the manual examination (palpation) of the woman is inadequate for accurately evaluating if a breast implant has ruptured. The study, The Diagnosis of Silicone Breast implant Rupture: Clinical Findings Compared with Findings at Magnetic Resonance Imaging (2005), reported that, in asymptomatic patients, only 30 per cent of the ruptured breast implants are accurately palpated and detected by an experienced plastic surgeon, whereas MRI examinations accurately detected 86 per cent of breast implant ruptures.[51] Therefore, the U.S. FDA recommended scheduled MRI examinations, as silent-rupture screenings, beginning at the 3-year-mark post-implantation, and then every two years, thereafter.[22] Nonetheless, beyond the U.S., the medical establishments of other nations have not endorsed routine MRI screening, and, in its stead, proposed that such a radiologic examination be reserved for two purposes: (i) for the woman with a suspected breast implant rupture; and (ii) for the confirmation of mammographic and ultrasonic studies that indicate the presence of a ruptured breast implant.[52]
A breast reduction typically includes a lift.  However, a lift does not necessarily require a reduction.  Both operations have similar incision patterns and resultant scars, but they have different indications.  One of the first questions I ask a patient who desires an improved appearance of her breasts is if she would like to be the same size, smaller, or larger.  The patient who wants to be the same size and is happy with her breasts when wearing a bra but unhappy with the amount of sagging without a bra is a candidate for a breast lift alone.  The patient who desires to be smaller or has one breast noticeably larger than the other, is a candidate for a breast reduction-lift combination.  Sometimes patients feel their breasts look smaller after removal of the excess skin with the lift even though no breast tissue was removed; the reason for this is that some of what fills your bra cup is excess skin.  The patient with sagging who desires to have larger breasts is a candidate for a breast lift with implants.
Recovery from fat transfer to the breast is relatively short. Patients will be advised on post-procedure bras and will have regular follow up with Dr. Mess. There will also be some recovery from the liposuction part of the transfer. In general, patients can return to normal activities in 2-3 weeks but are advised to avoid strenuous activity and any “fat burning” exercises for up to 6 weeks.

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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