Case 72: This patient had sustained a nasal fracture that caused a significant deviation of her nose. The fracture was corrected along with a septoplasty to improve breathing. Loss of tip support after the injury made her hump look more prominent and her tip felt more droopy. The bump was smoothened and her tip angulation restored to create the softer, more feminine profile she wanted. At the same time, fat transfer to the cheek and under eye area and subtle neck liposuction substantially improved the flat cheek and mid-face contour that previously made her feel hollowed and tired looking without makeup.
In the initial surgical consultation, patients should discuss their specific needs and aesthetic goals to ensure that these goals are realistic. While rhinoplasty can achieve dramatic results, the procedure will not completely alter a patient's appearance. Rather, it is intended to enhance an individual's beauty and correct minor to moderate imperfections. Fortunately, even small changes can have major, positive effects on a patient's overall appearance.
Private surgical suites, usually located in the surgeon's office, carry the least expensive facility fees. Usually ranging in cost from $1,000 to $3,000 per procedure, a private surgical facility can offer many advantages. The doctor is very familiar with the facility, and is likely working with the same staff members who have assisted in many previous surgeries. I operate in a certified private surgical facility where my patients enjoy the ultimate privacy and personalized care. In this setting, I am able to hand-pick each of my staff members personally, from nurses to anesthesiologists.
The majority of individuals who undergo nose reshaping surgery are dissatisfied with the appearance of their noses and wish to improve the proportions of their facial features. A smaller percentage of rhinoplasty candidates are patients who deal with discomfort or breathing difficulties due to structural abnormalities or previous nose injuries. The optimal candidates for rhinoplasty are in good general health, understand the risks associated with surgery, and have realistic expectations regarding the surgery results.
Make sure the surgeon you choose carefully analyzes both the outside and inside of your nose and presents you with a clear plan for how he intends to approach your surgery. Also, consider the quality of your communication and rapport with your surgeon. These qualities will help you choose a surgeon who truly listens and who takes your concerns seriously.
Some people opt for a temporary nonsurgical nose job—also called a liquid rhinoplasty—with hyaluronic=acid-based injectable fillers, like Voluma or Restylane Lyft. This minimally invasive procedure can camouflage bumps, create more symmetry, or lift and build up the tip of your nose. This approach has its limitations though. “If you have a large nose, it’s not going to get any smaller with fillers,” says Dr. Miller, though changes in proportions can sometimes make it appear smaller. It also can’t fix a crooked nose.
It is important that, no matter what the fee, you feel comfortable with your surgeon and confident in his operating ability. Although a rhinoplasty is the most difficult procedure for a facial plastic surgeon to perform, it is Dr. Torgerson’s specialty. He is not only an accredited surgeon, but has also received certification by the Royal College of Physicians and Surgeons of Canada to perform head, neck, and facial cosmetic surgery. Viewing before and after photos of his previous rhinoplasty patients will alleviate your anxiety ,and you will be confident that the fee charged is well worth the price!
The best reaction came from my mum, who is always honest. She isn’t afraid to tell me I look tired, pale or spotty, but when I saw her after my treatment she couldn’t have been more complimentary. After confiding in her that I had botox she yelped and said, ‘Wow you did really need it, now you look so fresh, like you’ve had a month of great sleep’. Thanks mum.
A revision rhinoplasty is a complicated surgery, because the surgeon now has to contend with thick scar tissue—which makes it difficult to raise the skin and soft tissue off the cartilage. “Plus, we often need to reconstruct part of the nose, so we need to take cartilage from other sources,” says Dr. Miller. Surgeons say that the minimum amount of time to wait before you can do revision rhinoplasty, even if there is an obvious problem, is a full year. 

Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, and trouble swallowing.

However, it’s not without real risks. A liquid nose job should be done only by a skilled plastic surgeon with extensive knowledge of facial anatomy, using only hyaluronic-acid-based fillers. Misplaced filler can cut off blood flow and cause skin necrosis (tissue death). If it’s caught quickly, the hyaluronic-acid filler can be dissolved by a doctor, using an injection of hyaluronidase. But because this risk is serious, fillers have not been approved by the U.S. Food and Drug Administration for use in the nose. 
Asian, Latin, and African American rhinoplasties require a special skill set. Surgeons say the challenge lies in reshaping and resizing the nose while retaining its distinct features and keeping it proportional to the face. “Typically, African American, Asian, and Latin noses have flat bridges and wide tips,” says Dr. Miller. “The number-one goal is to create a new tip [through cartilage grafting] that has better support.” Patients also often request a reduction in nostril size. 
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.
In recent years, medical tourism, or going outside the U.S. for a surgery or procedure, has become more popular. Patients go to other countries to have rhinoplasty and other surgery performed at a lower cost. While several other countries, such as South Korea, Columbia, and Italy, may have surgeons willing to perform rhinoplasty at a low cost, the quality and safety standards may not be as closely regulated as they are in the U.S.
There are several medically related Botox treatments that are usually covered by insurance, including treatment for blepharospasm (uncontrollable eye twitching), excessive sweating, constant pain, and others. Insurance coverage for cosmetic uses of Botox injections is much less common, but you should consult your insurance provider to find out if you have coverage for Botox treatment.
After relaying to Nurse Libbie that I didn’t want it to look ‘too frozen’, she agrees to give me 10 units across my forehead, and 15 in the centre of my frown- the average dose is between 10-25 units. I lay down across the bed in her treatment room and as she preps the solution, I’m asked to frown and raise my brows. As I do so she inserts the needle, and a tiny dose of botox by Allergen is inserted across six points of my forehead and in between my eyebrows. 

Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, and trouble swallowing.
1. Is your surgeon a board-certified plastic surgeon by the ABPS? The American Board of Plastic Surgery is the only certifying board in Plastic Surgery that is a member of the American Board of Medical Specialties.There are unfortunately quite a few physicians out there making money performing surgeries they have no training or experience to perform. Super low prices and wide open surgery scheduling availability are other bad signs this physician may not be up to standard.

Case 38: This beautiful young lady is an early 6 month example of a finesse rhinoplasty. On front view you can see the bridge is narrower and the sense of hang is improved. On profile, the tip looks undone, natural and less projected with correction of the slight hanging columella. The result is a beautiful, natural look that corrects the issues but leaves her looking totally natural and undone.
Case 40: Excessive nasal width can cause the nose to dominate other fine, delicate facial features. In Ethnic Rhinoplasty, the key to obtaining a more refined nose is to create a nasal framework upon which the thick skin will wrap around. This pretty young Persian woman wanted to reduce her nasal width, the fullness in her tip, and the sense that her tip was downturned. These six month photos show significant improvements in achieving these goals and her nose will only get better yet.
Although botox is now more widely available than ever before, it’s so important you see a qualified, experienced expert, even if they are more expensive. Yes, there are some clinics that will charge you super-low prices, but remember, if it seems too good to be true, it probably is. Before booking into the Cadogen Clinic I read countless positive reviews on Facebook and Google, yes at around £300 it might not have been the cheapest, but I knew I was in safe hands. Be smart and do your research people, after all, this is your face, you don't want f*ck it up.
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