Case 92: This procedure was all about correction of a droopy twisted tip. This patient was especially bothered by the tip’s tendency to drop and spread when she smiled, with a twist that made one nostril look higher than the other. After surgery, her nose is about as straight and symmetric as can be and the straighter bridge line makes her look younger.
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.
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.
© 2019 North Texas Plastic Surgery, PA. All rights reserved. Disclaimer: The information throughout this plastic surgery website is not intended to be taken as medical advice. Use of this website does not create a physician/patient relationship between you and North Texas Plastic Surgery, PA. The photographs of models displayed on this website are for decorative purposes only. See before and after photos for possible results. The information provided by North Texas Plastic Surgery is intended to provide general information regarding breast augmentation, liposuction, tummy tucks, facial plastic surgery, mommy makeovers, dermal fillers, and more for residents of Dallas, Plano, Southlake, DFW, and nearby areas of north Texas. This website is not intended for viewing or usage by European Union citizens. If you are interested in finding out more, please contact our plastic surgery office today for a personal consultation.
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]
When compared to the results achieved with a silicone-gel breast implant, the saline implant can yield acceptable results, of increased breast-size, smoother hemisphere-contour, and realistic texture; yet, it is likelier to cause cosmetic problems, such as the rippling and the wrinkling of the breast-envelope skin, accelerated lower breast pole stretch, and technical problems, such as the presence of the implant being noticeable to the eye and to the touch. The occurrence of such cosmetic problems is likelier in the case of the woman with very little breast tissue, and in the case of the woman who requires post-mastectomy breast reconstruction; thus, the silicone-gel implant is the technically superior prosthetic device for breast augmentation, and for breast reconstruction. In the case of the woman with much breast tissue, for whom sub-muscular emplacement is the recommended surgical approach, saline breast implants can produce an aesthetic result much like that afforded by silicone breast implants, albeit with greater implant palpability.[90]
For the second part....it depends where your butt is starting at. There is a point in which there is too much pressure in the butt that no more fat can really be injected. Pressure kills the fat cells (which is why you cannot sit on the butt for a few weeks after surgery). It also means that we cannot just keep injecting if the gluteus has fully expanded and is not able to take any more. If you are starting with a small butt.....there is a smaller limit. If you are starting with a medium sized butt.....there is a bigger limit. I like to use power assisted "vibration expansion filling" to really push the boundaries of how much fat can be injected into the buttocks. This helps to expand the buttocks on the table and get more fat into more stubborn areas. Typically, even for smaller girls, I will inject at least 1000ml per side (and up to 1600ml for larger girls). After this, as you have probably read, 30-50% of the fat will either reabsorb or "not take". However, with the removal of a large amount of fat around your midsection combined with careful technique and contouring of the butt and hips, we can make a very large difference in your overall proportion. Best of luck to you! 

In the past, concerns emerged that silicone implants posed health risks, including an increased risk of systemic diseases such as lupus and arthritis. The Food and Drug Administration (FDA) placed a moratorium on silicone implants in 1992 so the safety of these devices could be studied. However, in 2006 the agency concluded that there was no evidence of risk and lifted the moratorium.
A curvature and droopy tip brings undue focus to this young man’s nose. Although there is still some swelling in these early post-operative photos, we can already see a nose that is now straight, has a smooth profile and no longer droops. A sense of length is preserved to match his oval face. More than that, because of these positive changes, he also looks younger.
By and large, there is no 'perfect type' of breast implant. What looked stunning on one of your best friends doesn't necessarily mean that the same implant will be the best choice for you. This is why we recommend face-to-face consultations; an honest discussion with an experienced, knowledgeable plastic surgeon about your desired enhancement is a must. And you'll want to consider your surgeon's opinion and recommendations based on your existing body type and physical assessment.
Very slight changes to the structure of your nose — often measured in millimeters — can make a large difference in how your nose looks. Most of the time, an experienced surgeon can get results both of you are satisfied with. But in some cases, the slight changes aren't enough, and you and your surgeon might decide to do a second surgery for further changes. If this is the case, you must wait at least a year for the follow-up surgery, because your nose can go through changes during this time.
A: A breast reduction with lift procedure is tailored to your exact needs. You may be a candidate if your breasts are fully developed, you are experiencing physical or emotional discomfort caused by overly large breasts, are in good health, and have realistic expectations for the results of your surgery. A consultation with your doctor will help you determine the exact procedure you need.
The U.S. Food and Drug Administration established the age ranges for women seeking breast implants; for breast reconstruction, silicone-gel filled implants and saline-filled implants were approved for women of all ages; for breast augmentation, saline implants were approved for women 18 years of age and older; silicone implants were approved for women 22 years of age and older.[120] Because each breast implant device entails different medical risks, the minimum age of the patient for saline breast implants is different from the minimum age of the patient for silicone breast implants—because of the filler leakage and silent shell-rupture risks; thus, periodic MRI screening examinations are the recommended post-operative, follow-up therapy for the patient.[121] In other countries, in Europe and Oceania, the national health ministries' breast implant policies do not endorse periodic MRI screening of asymptomatic patients, but suggest palpation proper—with or without an ultrasonic screening—to be sufficient post-operative therapy for most patients.
It is certainly possible to lift a breast without changing the volume or removing any tissue, however, the breast will sometimes appear smaller after this procedure due to its position. It is also possible to reduce breast volume without lifting the tissue (usually via liposuction) but all reductions that are performed by making incisions will also include a lift.
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.
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.
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.
When compared to the results achieved with a silicone-gel breast implant, the saline implant can yield acceptable results, of increased breast-size, smoother hemisphere-contour, and realistic texture; yet, it is likelier to cause cosmetic problems, such as the rippling and the wrinkling of the breast-envelope skin, accelerated lower breast pole stretch, and technical problems, such as the presence of the implant being noticeable to the eye and to the touch. The occurrence of such cosmetic problems is likelier in the case of the woman with very little breast tissue, and in the case of the woman who requires post-mastectomy breast reconstruction; thus, the silicone-gel implant is the technically superior prosthetic device for breast augmentation, and for breast reconstruction. In the case of the woman with much breast tissue, for whom sub-muscular emplacement is the recommended surgical approach, saline breast implants can produce an aesthetic result much like that afforded by silicone breast implants, albeit with greater implant palpability.[90]
2000 European Union European Committee on Quality Assurance & Medical Devices in Plastic Surgery (EQUAM) "Additional medical studies have not demonstrated any association between silicone-gel filled breast implants and traditional auto-immune or connective tissue diseases, cancer, nor any other malignant disease. . . . EQUAM continues to believe that there is no scientific evidence that silicone allergy, silicone intoxication, atypical disease or a 'new silicone disease' exists."[34]
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.
If you have considerable sagging, pendulous breasts, an anchor lift, which allows a cosmetic surgeon to remove a significant amount of excess skin and sagging tissues, may yield the best results. This technique involves 3 incisions: one around the edge of the areola, one vertically from the bottom of the areola to the breast crease, and one along the inframammary fold, hidden in the breast crease. Your cosmetic surgeon may also use this technique if you are having a breast reduction with lift. While the anchor lift comes with some visible scarring, these typically will fade significantly with proper care, and are easily hidden by a bikini top.
Breast implants are not lifetime devices and breast implantation may not be a one-time surgery. The most common complications for breast augmentation and reconstruction with MemoryGel® Implants include any reoperation, capsular contracture, and implant removal with or without replacement. The most common complications with MemoryShape® Implants for breast augmentation include reoperation for any reason, implant removal with or without replacement, and ptosis. The most common complications with MemoryShape® Implants for breast reconstruction include reoperation for any reason, implant removal with or without replacement, and capsular contracture. A lower risk of complication is rupture. The health consequences of a ruptured silicone gel breast implant have not been fully established. MRI screenings are recommended three years after initial implant surgery and then every two years after to detect silent rupture. The most common complications with MENTOR® Saline-filled Implants include reoperation, implant removal, capsular contracture, breast pain, and implant deflation.

Great question!  Without seeing you it is difficult to make an accurate assessment.  However as a general rule, the maximum amount of liposuction that can be performed in an outpatient setting, is around 5 liters due to the vast amount of fluid shift.  After filtration of the fluid, blood, devitalized fat cells, and lipids, generally you are left with about 2 liters of mature viable fat for injection.  Which means 1 liter to each side - which is a lot.  Take into account that you will loose anywhere from 20-40% of the volume so now we are at about 600-800cc's that will remain...that is with a maximum of 5 liter of liposuction.  If you have more than 5 liters of fat, then you may need to undergo this procedure a second time in order to harvest more fat for injection.


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.”
Case 78: A combination approach was used here to create a really meaningful but completely natural transformation. Otoplasty made prominent ears all but disappear from the field of view and no longer distract or draw attention. At the same time, rhinoplasty, chin augmentation, and neck liposuction accomplished were able to remove a nasal hump and overprojection while improving chin and neck laxity to achieve a nice overall balance.
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.

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.
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.

In some cases, a breast lift alone may not achieve a patient’s desired results. If you feel your breasts look “deflated” or have lost volume due to aging, weight loss, or pregnancy, your cosmetic surgeon can place breast implants during breast lift surgery to restore fullness and shape to the breast. If you have always wanted larger, lifted breasts, a breast augmentation with lift can help you achieve both with a single procedure and recovery.

Dr. Mess receive patients from many for Washington DC and nearby cities and performs the fat transfer in her office in Columbia, Md, at Northwest Hospital near Baltimore, and at Howard County General Hospital. There are different techniques for fat transfer depending on the area being treated; small volume to face and hands vs. medium volume to enhance breast reconstruction vs. large volume to enhance buttocks and augment breast without implants. Common donor sites are the patient’s abdomen, thighs, or love handles.  The fat is suctioned by hand for small volume and by liposuction machine for large volume.  The fat is gently separated to concentrate the viable fat from fluid and nonessential matter.  The concentrated fat is re-injected into the desired area with small cannulas designed to maximize the survival of the transferred fat.  Dr. Sarah Mess has spent years refining her fat transfer technique to offer her patients outstanding fat transfer outcomes.
Case 78: A combination approach was used here to create a really meaningful but completely natural transformation. Otoplasty made prominent ears all but disappear from the field of view and no longer distract or draw attention. At the same time, rhinoplasty, chin augmentation, and neck liposuction accomplished were able to remove a nasal hump and overprojection while improving chin and neck laxity to achieve a nice overall balance.
Subglandular: the breast implant is emplaced to the retromammary space, between the breast tissue (the mammary gland) and the pectoralis major muscle (major muscle of the chest), which most approximates the plane of normal breast tissue, and affords the most aesthetic results. Yet, in women with thin pectoral soft-tissue, the subglandular position is likelier to show the ripples and wrinkles of the underlying implant. Moreover, the capsular contracture incidence rate is slightly greater with subglandular implantation.
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]
I had gauze under my nose to catch the blood but otherwise looked pretty normal, as the swelling and bruising hadn't set in yet. I wasn't in much pain — I described the sensation to a nurse as a bad sunburn, tight and sore. I could breathe so freely through my nose, which was something new for me. Dr. Kolker had fixed a valve in there — a sweet bonus.
The ASPS and the Plastic Surgery Foundation (PSF) have partnered with the FDA to study this condition and in doing so created the Patient Registry and Outcomes For breast Implants and anaplastic large cell Lymphoma Etiology and epidemiology (PROFILE). The United States FDA strongly encourages all physicians to report cases to PROFILE in an effort to better understand the role of breast implants in ALCL and the management of this disease.[74]
Case 29: Major concerns for this patient were widening of the tip with a marked lack of projection which made his nose feel flat and washed out. Nostril thickness and rounding was also something he wanted addressed. In this case, irradiated donor rib cartilage was used to project and support the tip along with alar base reduction removing a significant amount of nostril flare to create a natural tip and nostril contour that is ethnically appropriate. Fat transfer to the cheeks helps to balance out his flat mid-face to strengthen the cheek contour which can be seen nicely on the profile view.
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.
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.
Make sure your cosmetic surgeon is board certified; this ensures that he or she is specifically trained and experienced in cosmetic surgery and that your procedure will take place in an accredited facility, which is essential for your safety. Finally, don’t choose a cosmetic surgeon based on price alone. Your safety & results are too important. Most cosmetic surgeons offer financing options to help patients budget procedure costs.

Case 78: A combination approach was used here to create a really meaningful but completely natural transformation. Otoplasty made prominent ears all but disappear from the field of view and no longer distract or draw attention. At the same time, rhinoplasty, chin augmentation, and neck liposuction accomplished were able to remove a nasal hump and overprojection while improving chin and neck laxity to achieve a nice overall balance.
This photo gallery represents a cross-section of my rhinoplasty practice and includes patients of different age, gender, nasal shape, and ethnic background. This gallery is not a collection of my best rhinoplasty outcomes, but rather a representative sampling of my typical cosmetic result. In addition, a majority of these patients also had simultaneous correction of severe nasal breathing difficulties, which cannot be appreciated in photographs.
The ‘gummy bear’ implant comes in both round and teardrop shapes. They have a firmer gel, which may give a better shape and may last longer. The round gummy bear implant is often a good choice for women with looser tissues and who want a more durable implant that remains soft. The teardrop shaped gummy bear implant may be a good choice for women whose tissues are relatively tight and desire a very proportionate and natural looking enhancement with less fullness of the upper portion of the breast and more projection and fullness of the lower portion of the breast.
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