Then he took a bunch of pictures from different angles and stepped out to review them. A few minutes later, we sat down in his office to go over the images. He showed me three distinct perspectives: front, profile, and from below, which he called the worm's-eye view. With each photo, he presented a revised image of what my nose could look like with surgery — and, wow, what a rush of happiness! It was honestly everything I was hoping for: smoother and smaller, but still me.

Thank you for your question its hard to answer your question without pictures or an evaluation. I my experience the more fat transferred the better results.  Areas to consider would be your abdomen, back bra rolls and flanks at times Inner Thighs and Knees. This would be based on your current projection and how much fat you have to give. Removing the fat from the back bra rolls and waist alone can greatly improve your overall shape and enhance your curves. Once your waistline is more defined like an hourglass you will be able to see your buttock shape. Then once the fat is transferred to the buttock you will get more projection. It's best to consult with a Board Certified Plastic Surgeon to get an examination to assess the areas and outcome. Best of luck.
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.
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.
Many women are tempted to brush aside the idea of complications when asking how much do breast implants cost, thinking it won’t happen to them. Knowing your statistical risk of complications will help you plan ahead and pick an implant that is more likely to keep you out of complex surgery in the future. For primary augmentations, silicone gel implants have a higher complication rate for both capsular contracture (10.9-16.2% at 7-8 years) and implant rupture (7.2-13.6% at 8 years), than the IDEAL IMPLANT. “The silicone gel from a ruptured implant can stick to the tissues on the chest wall and a capsulectomy is often required,” explains Dr. Mahony. “The warranty may not fully cover these costs. In contrast [for primary augmentations] structured breast implants have a capsular contracture risk of only 6.6% and a rupture risk of only 2.1% at seven years, with revision surgery generally being less invasive.” Dr. Larry Nichter, board-certified plastic surgeon in Newport Beach, California, tells us about the likelihood of subsequent surgeries with IDEAL IMPLANT saying, “It’s incredibly safe and so there’s far fewer lifetime surgeries with an IDEAL IMPLANT Structured Breast Implant, compared to silicone gel implants.”
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]
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.
From the first half of the twentieth century, physicians used other substances as breast implant fillers—ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol—formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.[111]
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.
Transumbilical: a trans-umbilical breast augmentation (TUBA) is a less common implant-device emplacement technique wherein the incision is at the umbilicus (navel), and the dissection tunnels superiorly, up towards the bust. The TUBA approach allows emplacing the breast implants without producing visible scars upon the breast proper; but makes appropriate dissection and device-emplacement more technically difficult. A TUBA procedure is performed bluntly—without the endoscope's visual assistance—and is not appropriate for emplacing (pre-filled) silicone-gel implants, because of the great potential for damaging the elastomer silicone shell of the breast implant during its manual insertion through the short (~2.0 cm) incision at the navel, and because pre-filled silicone gel implants are incompressible, and cannot be inserted through so small an incision.[75]
Case 94: This patient was seeing the early signs of facial aging including loss of skin tone and elasticity, early jowling, and heaviness under the chin. A lower facelift along with fat transfer to the under eye and cheek area substantially improved the contour and even apparent texture of her skin, making her look noticeably younger. In addition, the overall effect was completed with a rhinoplasty focused on reducing the width, rounding, and thickness of her tip and nostrils which is a challenge in the setting of thick skin.
These placements vary from shallow (subglandular) to deep (complete submuscular). The right placement for your breast implants is based on your anatomy as well as your goals and expectations. You should express your desires to your surgeon, but make sure to take his or her expert opinion into account. Improper implant placement can create complications such as breast augmentation double bubble, wrinkles and rippling.
Does the nipple/areola sit below the crease underneath my breast? One trait cosmetic surgeons frequently look for when evaluating a breast lift candidate is the position of the nipple/areola in relation to the inframammary fold, or crease beneath the breast. Try this test: slide a plain sheet of paper underneath your breast (no bra) so it sits against the breast crease. When looking in the mirror, do your nipples sit below the top edge of the paper? If so, this is a good indication that you have enough sagging to warrant a breast lift.
Many different types of breast lifts are now available in conjunction with a breast reduction, including lifts just around the areola (periareolar), vertical/lollipop mastopexies (incision around the areola and down to the breast fold, and full breast lifts with an anchor incision. For patients who have very loose skin in the armpit or back, axillary or bra lifts are also often combined with breast reductions.
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]

Dr. Rotemberg will not only explain to you what to expect during the recovery process, will also detail the recovery process in take home instructions for you. She wants her patients to know that recovery is not a one size fits all, and while she creates an individualized program for recovery for each patient, she knows that questions and concerns may come up during this period. She would prefer if you have any questions or concerns at any time during the recovery process that you contact her or her friendly and knowledgeable staff.


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.

Saline-filled breast implants contain a silicone outer shell filled with a sterile saltwater (saline) solution. Some are pre-filled and others are filled during the implant operation. Saline-filled implants come in different sizes and have either smooth or textured shells. The FDA approved saline-filled breast implants for breast augmentation in women age 18 or older and for breast reconstruction in women of any age. They are also used in revision surgeries, which correct or improve the result of an original surgery.
Dr. Cohen specializes in breast lifts, augmentations, revisions and reductions as well as breast cancer reconstructions. A long time dream of Dr. Cohen’s was to travel to developing countries and provide expert surgical care to those who have no other possible access to medical care. This became a reality in 2007 when she became a founding member and Vice President of ISMS Operation Kids.
Case 46: A hump and hanging tip cause the nose to dominate otherwise beautiful features in this young woman. In this case, a tip lift, hump reduction, and tip refinement preserves some of her rounded appearance, very naturally enhancing her pretty eyes. On the bottom view, we see a good example of how open rhinoplasty incisions should heal virtually undetectably when done with care.
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]
Breast reconstruction may be performed after mastectomy, to rebuild injured or congenitally deformed breasts, or as part of gender reassignment surgery. As part of the reconstruction process, a breast tissue expander may be used to stretch the patient's tissue for insertion of an implant or the patient's own tissue. Tissue expanders are like thick-walled silicone balloons, come in different sizes and shapes, and may have a smooth or textured outer surface. They are implanted under the breast skin, tissue, or chest muscle, and are regulated by the FDA as medical devices. In immediate reconstruction, the expander is inserted immediately following mastectomy. For patients who choose delayed reconstruction, the expander is implanted in a separate surgery months or years later.
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]

Does the nipple/areola sit below the crease underneath my breast? One trait cosmetic surgeons frequently look for when evaluating a breast lift candidate is the position of the nipple/areola in relation to the inframammary fold, or crease beneath the breast. Try this test: slide a plain sheet of paper underneath your breast (no bra) so it sits against the breast crease. When looking in the mirror, do your nipples sit below the top edge of the paper? If so, this is a good indication that you have enough sagging to warrant a breast lift.


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]
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.
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.
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.
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.”
2009	European Union	International Committee for Quality Assurance, Medical Technologies & Devices in Plastic Surgery panel (IQUAM)	The consensus statement of the Transatlantic Innovations conference (April 2009) indicated that additional medical studies demonstrated no association between silicone gel-filled breast implants and carcinoma, or any metabolic, immune, or allergic disorder.[38]

Transaxillary: an incision made to the axilla (armpit), from which the dissection tunnels medially, to emplace the implants, either bluntly or with an endoscope (illuminated video microcamera), without producing visible scars on the breast proper; yet, it is likelier to produce inferior asymmetry of the implant-device position. Therefore, surgical revision of transaxillary emplaced breast implants usually requires either an IMF incision or a periareolar incision.
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