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.
Case 22: This young woman was happy with her profile but wanted to reduce nasal width, tip boxiness, and nostril flare on front and three-quarter views. The combination of narrowing her bridge, tip refinement, and nostril reduction helped bring her nose into balance. At the same time, fat transfer to the under eye hollows did a fantastic job of brightening her eyes and giving her a more youthful look.
Potential candidates should also have adequate fat reserves for transfer. This becomes especially important when one considers the anticipated rate of fat resorption and graft loss. I typically recommened patients aim for at least 500 cc transferred per cheek. This would amount to 1 liter of fat (not lipoaspirate) after processing. Candidates with inadequate fat reserves are likely to be disappointed with their ultimate volume once healing is complete.
Your medical history. The most important question your doctor will ask you is about your motivation for surgery and your goals. Your doctor will also ask questions about your medical history — including a history of nasal obstruction, surgeries and any medications you take. If you have a bleeding disorder, such as hemophilia, you may not be a candidate for rhinoplasty.
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.
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.
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.