Case 60: Facial aging can be hard on someone who is naturally thin by creating a more severe and skeletonized appearance as facial fat is lost. A combined approach was used to create a beautiful transformation, including a trichophytic brow lift, lower lid tightening, and facelift along with a conservative rhinoplasty to straighten and balance her nose. Notice how the eyes are opened up and facial hollows are smoothened without the surprised look that can accompany over-aggressive lifts. You’ll also see that incisions are hidden within the hairline and natural skin creases making them almost invisible.
In most cases, doctors advise teenage patients to wait until their noses have stopped growing before they undergo rhinoplasty. There are exceptions, however, especially in cases of trauma or breathing difficulties. When young patients undergo rhinoplasty, the doctor must take special care to protect the still delicate nasal features. Additionally, a doctor should make sure that the patient is emotionally and mentally prepared for nose reshaping surgery.
In the initial days after rhinoplasty, it is important that the changes to the nasal tissue be preserved. After closing the incisions made during surgery, a surgeon will place a splint to help retain the new shape of the nose. In some cases, the doctor may also place pieces of gauze, or nasal packing, inside the nostrils. The material will help reduce bleeding and keep the septum in place. The gauze may cause some discomfort. However, it is typically removed within a few days of surgery, and goes a long toward maintaining the results of surgery.
Avoid blood-thinning medications such as Ibuprofen (Motrin or Advil), Aspirin, naproxen (Aleve) for 5 days prior to your treatment and for 3 days after.  These may increase your chances of bruising.  Inform your doctor if you are on any prescription blood thinning medications (do not stop taking prescription medications unless specifically instructed to do so).
The cost of the implants themselves ranges from about $1500-$4000. Usually when you ask a Doctor to give you a quote for this surgery they quote the entire price of the surgery (the implants, anesthesia, overhead, etc.) The cost for breast augmentation surgery is usually $7500-$9500 before taxes. If you would like a breast lift, this would be additional cost. Generally what causes the range in cost is the type of implant (saline, silicone, anatomical, etc.) Usually the number of cc's you decide upon will not effect the cost. There is financing usually available as well. Best of luck!

Patients who are unhappy with their previous nose job results are candidates for secondary rhinoplasty. Whether the nose is deemed too small, too large, or improperly shaped, a skilled surgeon may be able to correct the problem. Patients who experience breathing difficulties following rhinoplasty may also opt to undergo a second procedure. Factors influencing candidacy for revision rhinoplasty include:
It's the anticipation. We all tend to worry about new things we are unfamiliar with, and rhinoplasty surgery is one of those things. If you've never had surgery before, it's not unusual to be nervous and worry about every little detail. Will it hurt? Will I be in pain? When rhinoplasty is performed using a general anesthetic, you won't remember the procedure and you won't feel a thing. Most patients wake up after surgery realizing there was nothing to be scared about – and feeling silly for having worried at all.
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.
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.
Case 47: This patient’s primary surgery left her with valve collapse, nostril notching, persistent tip rounding and hanging columella. Secondary surgery involved correction of these issues with repositioning and reconstruction of the tip cartilages to improve tip contour. Although she is still a little swollen in the after photos, she is already happy with her new nose.

Patients who are unhappy with their previous nose job results are candidates for secondary rhinoplasty. Whether the nose is deemed too small, too large, or improperly shaped, a skilled surgeon may be able to correct the problem. Patients who experience breathing difficulties following rhinoplasty may also opt to undergo a second procedure. Factors influencing candidacy for revision rhinoplasty include:
Skilled cosmetic surgery can help make your outside look more the way you want, and that can mean important changes in the way you feel inside and the way you interact with people around you. The opportunity to improve your appearance through cosmetic surgery is exciting, yet it represents a major decision in your life. It is important that you seek the assistance of a trained and skilled physician, one who possesses a vast knowledge of the options individually available to you, and the expertise and empathy to help you realize them, a physician such as Dr. Richard Clark.
Unfortunately, despite a surgeon's best efforts, in some cases a patient may be unhappy with the results of his or her surgery. This can result from numerous causes, including surgical error or unrealistic expectations on the patient's part. Because the final results of rhinoplasty can take up to a year to develop, patients should not panic if their noses have not taken their ideal shape in the first few months. If a patient is unhappy with the nose even after the final shape has stabilized, there are options for treatment and correction. Depending on the extent of changes that need to be made, a surgeon may recommend non-surgical nose reshaping or secondary (revision) rhinoplasty.
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.
After the patient is sedated, the surgeon creates tiny incisions inside the nostrils or on the columella. Then he or she carefully lifts the skin to access the underlying bone and cartilage. The surgeon can then remove or graft tissues, as needed. Typically, a doctor uses conservative methods to minimize the impact to the surrounding tissues while still achieving the desired results. When the reshaping process is complete, the doctor lays the skin back down over the new contours of the nose and closes the incisions.
Post treatment I was a left a little red and blotchy, so I cancelled any meetings I had straight after. Although the redness soon faded I was left with a few tiny pin prick points. I am told that bruising is common, but it all depends on how sensitive your skin is. I was also left with a slight headache, almost like I’d been wearing a swim cap for a few days. This too didn’t last longer than a few hours, and wasn’t anything that two paracetamol couldn’t fix. If you do experience a headache for longer than 48 hours, or any other symptoms like nausea or visual disturbances (although rare) you are advised to contact your practitioner.
Case 25: This patient had what is called a tension nose wherein a convexity on the bridge pushes the tip forward and down. Notice how this also puts tension on the upper lip and appears to tether it from inside. a combination of straightening, improving breathing, removing the hump, and setting the tip appropriately also helps to relax the upper lip and complete the look.
Open rhinoplasty gives the surgeon greater access to the cartilage and bone of the nose but it will leave some scar tissue. By creating an incision across the columella (the area of cartilage between the two nostrils) the doctor can lift the skin off the tip of the nose and shape the cartilage very precisely. When healed, the incision leaves a very small, almost negligible scar on the underside of the nose.
6)What else is included with your surgery?  Some are bare bones deals - you get your implants and good bye, while others include a comprehensive pre-surgical assessment, and a thorough post-surgical follow up.  (we've heard from other patients about their friends getting their BA elsewhere, and after the surgery they saw their surgeon only at one week after surgery and never again!  We don't do that ... at our clinic you are welcome to come back and see us as often as needed, and we have a schedule of follow up visits for a full year after your surgery to ensure you get the best results possible.)

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).
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