The closed vs. open rhinoplasty technique concerns only how the surgeon gets inside the nose to make the required changes, not what’s accomplished with the rhinoplasty procedure itself. Reshaping your nose may include breaking and removing bone and cartilage. If cartilage needs to be added, say, to rebuild the tip of the nose, it’s often taken from the septum, the middle portion of the nose—a technique called a cartilage graft. Cartilage may also be taken from other areas of your body, such as your ear. In some cases, a synthetic material, like a silicone implant, is used; but studies have shown that there may be more complications with synthetics. Cartilage grafts, nasal-bone osteotomies (removal of parts of the bone), dorsal-hump removal, and suture techniques applied to the nasal tip cartilages can all be performed with either the closed- or open-approach rhinoplasty.

Within a week, the transmission of a nerve impulse causing a contraction of muscle is gradually stopped. It stretches, the skin is straightened, fine wrinkles disappear completely, and the deep ones become less pronounced. Its peak effect of botulinum toxin reaches two weeks later and lasts from 4 to 6 months. During this time, the tissues remember their new relaxed state and the subsequent introduction will preserve the effect of the drug for a longer period (up to 8 months). It should be noted that the procedure should be conducted no more than 2 times a year, otherwise excess doses of toxin can cause the formation of antibodies in the body and provoke immunity to the action of the drug.
Do not receive BOTOX® Cosmetic if you: are allergic to any of the ingredients in BOTOX® Cosmetic (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.
Because rhinoplasty is an elective cosmetic procedure, for the majority of people, their insurance will not cover it.  If you have a deviated septum or a serious defect that affects your breathing, you may be able to have insurance cover some of the nose job cost for this septoplasty. An injury, illness or cancer that causes you to lose part of your nose can require a reconstructive rhinoplasty, which may also be partly covered by insurance. This will require preauthorization by the insurance company and other tests or scans to verify the defect.
Dr. Miller says it’s also important for patients to have realistic expectations. “It’s not a good idea to take a wide, thick nose and turn it into one that’s thin and tiny,” he says. “But if the steps are done properly, we can make the desired changes.” Thick nasal skin that makes it challenging to refine the nasal tip needs to be thinned out, for example. It’s important to find a board-certified facial plastic surgeon who specializes in ethnic rhinoplasties. 

A few weeks before your surgery, you will meet with the surgeon to discuss your personal goals and plan out the procedure. You will also have follow-up appointments post-op to monitor your progress. After surgery, you will need ice packs, gauze and certain pain medication for pain management purposes. All of these pre and post-op appointments and supplies are necessary to take into account when determining what the overall cost of the procedure will be. Be sure to ask your surgeon’s office whether appointments and supplies are included as a package cost and what, if any, additional supplies you may need to buy as you recover from your nose job.

Additional costs may vary depending on whether the patient is having surgery in a surgery center, physician’s office, or a hospital setting. Patients should also determine whether or not the lab work will be included in the quote. Options that are not included in the basic surgical costs can be placement of a pain pump, or use of a Keller Funnel for implant placement. Thus, the average price of breast implants will vary depending on the circumstances.
A rhinoplasty reshapes your nose, changes the shape of your nostrils, removes a bump or corrects an injury to the bridge of your nose, or addresses other issues, such as breathing problems. In some cases, people choose to have a nose job in order to correct a defect in the nose that makes it difficult to breathe. In short, a good nose job is one that achieves your personal vision for the surgery and doesn’t require additional procedures.
It is also possible for implants to rupture and leak. If saline implants rupture, the saline will be safely absorbed by the body. A silicone leak may stay inside the implant shell or leak outside of the shell. When a saline implant ruptures, it will deflate. But silicone breast implants may cause no obvious symptoms when they rupture. This is called silent rupture.
Tell your doctor about all your medical conditions, including: plans to have surgery; had surgery on your face; have trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® Cosmetic can harm your unborn baby); are breast-feeding or plan to (it is not known if BOTOX® Cosmetic passes into breast milk).
As with any medical/surgical treatment, individual results may vary. Only a surgeon/physician can determine whether reconstruction or augmentation>is an appropriate course of treatment. The following are general adverse events associated with breast implant surgery: Device Rupture, Capsular contracture, Infection, Hematoma/Seroma, Pain, Reoperation, Implant removal, changes in Nipple and Breast Sensation, unsatisfactory results, breast-feeding complications. Other reported conditions are listed in the Product Insert Data Sheet (PIDS). See full list in the PIDS for the product information. These potential adverse events, including contraindications, warnings, and precautions need to be discussed with your doctor prior to surgery.
One final note: In today's rough-and-tumble economy, many specialists with little or no training in the field of plastic surgery are turning to cosmetic procedures to increase revenues. They are also offering these procedures at reduced costs. Don't be fooled. Many of these practitioners have only taken a weekend course on how to perform your surgery. You get what you pay for.
After care from the experts was pretty simple and didn’t require anything too strenuous. To keep results looking optimum I’m told to avoid things such as smoking, excess alcohol, sun exposure and getting stressed - which can all help break down collagen faster, decreasing the longevity of Botox. ‘I always recommend that my clients use a daily antioxidant topical serum and an SPF 50 too,’ advises Spyrou.

How much you’ll swell really depends on you and on your surgeon’s technique—not so much the type of rhinoplasty you had. Dr. William Portuese, a facial plastic surgeon in Seattle, says that “The amount of swelling after a rhinoplasty procedure depends upon the type of rhinoplasty performed [open versus closed], the thickness of the skin, the amount of alteration required to the nasal tip, and the patient’s variability with the healing process itself.” He notes that “Some patients require taping and steroid shots in the tip of the nose to reduce swelling in that area for the first several months after the procedure.” According to Dr. Miller, “A very clean open rhinoplasty can result in minimal swelling, while with a closed procedure that isn’t performed in the ideal tissue and cartilage, you can have a lot more swelling. If the dissection travels through soft tissue or muscle on top of the cartilage, more bleeding and swelling will develop.” He notes that most people can also expect some bleeding from days two to five, but it should lessen with each passing day.
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