The FDA approved such usage in the late1980s when it was discovered that Botox could stop ailments such as uncontrolled blinking and lazy eye. Cosmetic physicians have been using Botox for years to treat wrinkles and facial creases. Botox is an approved treatment for frown lines on the forehead, crow’s feet (lines around the eye), and axillary hyperhidrosis (increased sweating of the armpits).
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.
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.
Our plastic surgeons, injectors, and medical aesthetician individualize the cost of treatment for you depending on exactly what you need done. Every patient is different, and fees are based on the complexity of your case, as well as the amount of time it would take to do your procedure. We can only provide a definite quote after you have been seen for your consultation.

Meeting with multiple prospective surgeons is also a great way to make your choice. Make sure you are comfortable speaking to the surgeon, and make sure he or she asks you plenty of questions, and does not rush you through any part of the consultation. After you have fully described your goals, the surgeon should provide you with informative, thoroughly explained options.
The results are usually permanent, aside from normal changes that come with the aging process. If you’re really not happy with your results or have breathing difficulties once your nose has healed, you may be a candidate for a revision rhinoplasty. In many cases, scar tissue is the main culprit. “The force of a scar is very strong,” says Dr. Miller. “It can pull a nose one way or another—push it in, pull it out, turn it.” When this happens, a surgeon has to go back in and tweak the work. 

On the day of your surgery, you should not eat anything before the procedure. Because chewing involves moving the entire face, doctors typically recommend a soft or liquid diet for the first several days. You will be able to return to solid food whenever it is comfortable for you. Additionally, you should avoid spicy foods, as they can constrict the blood vessels and lead to increased bruising.


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.
The FDA approved such usage in the late1980s when it was discovered that Botox could stop ailments such as uncontrolled blinking and lazy eye. Cosmetic physicians have been using Botox for years to treat wrinkles and facial creases. Botox is an approved treatment for frown lines on the forehead, crow’s feet (lines around the eye), and axillary hyperhidrosis (increased sweating of the armpits).
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.
Dr. S. Valentine Fernandes, the Conjoint Senior Clinical Lecturer, at the Department of Otorhinolaryngology, Newcastle University, conducted a comprehensive study about the risks of rhinoplasty. According to Fernandes, the complication rate of nose surgery falls between 4 and 18.8 percent. While this may seem an alarming number, Fernandes reports that there is a much lower 1.7 to 5 percent risk of life threatening complications. He also notes that the complication rate falls in proportion to the doctor's surgical experience.
This 45-year old female patient came to us frustrated with furrows between her brows. As we have with many other patients, we created and recommended a treatment plan that started with Botox injections. As you can see, even holding the same expression as before, the lines have nearly disappeared in these forehead lines before and after pictures. Results this powerful are possible for you, too. 

Many patients choose to combine rhinoplasty with a facelift for dramatic results and an overall more youthful appearance. This procedure can treat creases and sagging skin, particularly around the eyes, cheeks, chin, and mouth. There are several types of facelifts, and patients can choose a mid, mini, or lower facelift to address specific areas of concern. Through carefully concealed incisions, the doctor raises the facial muscles, removes unwanted fat deposits, and trims away extra skin. Following a facelift, patients may look significantly younger.

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.


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. 
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.
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The FDA approved such usage in the late1980s when it was discovered that Botox could stop ailments such as uncontrolled blinking and lazy eye. Cosmetic physicians have been using Botox for years to treat wrinkles and facial creases. Botox is an approved treatment for frown lines on the forehead, crow’s feet (lines around the eye), and axillary hyperhidrosis (increased sweating of the armpits).
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.
In addition to the physical benefits of rhinoplasty, the procedure has psychological benefits as well. Individuals who are unhappy with the size or shape of their nose often feel self-conscious about their appearance and may suffer from low self-esteem. After undergoing rhinoplasty surgery, however, many patients report a marked boost in confidence. This benefit alone can be a great reason for patients to choose rhinoplasty.
Rhinoplasty is a highly personal procedure that can affect a person's mental well-being, as well as his or her appearance. Therefore, it is vital that patients choose a surgeon with whom they feel comfortable. They should select a doctor who truly listens to their concerns, answers their questions, and creates a treatment plan that will address their specific goals. Patients should never choose someone who makes unrealistic promises or pressures them to undergo more surgery than they actually want.
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. 
Once your bone and cartilage have been resculpted, your surgeon pulls the skin back down and stitches it along the open-rhinoplasty incision across the columella (the tissue that links the nasal tip to the nasal base). “When done properly, that incision is extremely hard to see, once it’s healed,” says Dr. Miller. With a closed procedure, the incisions are made inside your nostrils, so there’s no visible scarring, and the sutures are usually dissolvable. 
The minimum age for rhinoplasty depends on both physical and emotional maturity. It's important to wait until your facial growth is complete, which is approximately at age 14 or 15 for women and in the late teens for men. There is no upper age limit for rhinoplasty, as long as you are in good general health. Many women and men come to Dr. Rival for nose surgery in their 40s and 50s.
We here at Surgeons In Canada have seen a significant increase in patients from the United States coming to Canada to have their breast surgery. This is a wise choice for many Americans as boob jobs in Canada can be quite a bit cheaper due to the currency exchange rate. Currently women from the U.S. can easily save anywhere from $2000 – $5000 dollars on their breast augmentation by coming to Canada.
The Ministry of Health will usually cover the portion of the procedure that is done to correct a breathing problem (septoplasty or turbinate reduction). Sometimes the Ministry of Health will cover septorhinoplasty to straighten a deviated nose when this occurs as the result of trauma or congenital birth anomaly. This requires prior approval from the ministry. Private insurance plans generally do not cover cosmetic surgery.

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.
A rhinoplasty, commonly called a nose job, is a surgical procedure that changes the shape and, often, the size of your nose. If your nose has a prominent bump, crooked bridge, or wide tip, or it seems too big (or even too small) in relation to the rest of your facial features, surgical rhinoplasty could be your best option to correct it. It’s sometimes combined (and often confused) with a septoplasty—the surgical correction of a deviated septum, a condition where the wall between your nasal passages is crooked. A septoplasty is performed to improve breathing, while a rhinoplasty is usually performed for cosmetic enhancement.  Both procedures can be performed simultaneously under one anesthetic, with one recovery period.
‘You’ll start to see an effect after 3-5 days’, instructs cosmetic doctor Rita Rakus, ‘however it may take two weeks for maximum results to kick in’. For me, my forehead had less movement after day three, but it wasn't until a full week after the treatment that it felt completely immobile. It’s definitely a strange sensation as you go to lift your brows…but nothing moves.
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.
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.

When doctors operate at these outpatient centers, they should have hospital privileges with at least one local medical center. A doctor must pass rigorous screenings to earn these privileges, so patients can rest assured that their surgeon maintains proper ethical and safety standards. Surgical complications during rhinoplasty are extremely rare. However, hospital privileges ensure that a patient will have access to emergency care in the unlikely event that something does go wrong.
Rhinoplasty is one of the most popular cosmetic surgeries among teenagers. It is important for teenage patients and their surgeons to consider whether or not nose reshaping is an appropriate cosmetic surgery option. Doctors should ensure that the decision to undergo rhinoplasty is the patient's own choice, rather than the result of peer or parental pressure. Regardless of the reason for surgery, doctors recommend that girls wait until age 14 or 15, and that boys wait a few additional years to undergo rhinoplasty. By this time, the nose should have finished growing.
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