Because the nose plays such a prominent role in the facial structure, many patients choose to have additional treatments along with their nose jobs. These procedures can help to maintain the balance of the face and provide more dramatic results. In most cases, combining rhinoplasty with one or more additional treatments is quite safe. However, to ensure safety and good results, patients should choose surgeons who are experienced in all areas of facial plastic surgery.
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.
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.

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.


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.
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.
The consultation is your chance to get acquainted with the doctor and find out if you two see eye to eye. It is also your opportunity to explain why you want to have rhinoplasty and what your particular goals are. You will sit down with the doctor and tell him or her about your nose and what you would like to change. If you've had any previous nasal surgery or have broken your nose in the past, the doctor will want to know about that, too. If you have pictures of noses you like, bring them along so the doctor can get an even clearer idea of what you're hoping for. The doctor will examine your nose and explain what changes can be achieved and how the procedure will be performed.
Tell your doctor if you have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (tell your doctor exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-like products or blood thinners.
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.
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).
If you’re having what’s called an open rhinoplasty, the surgeon will make an incision (about 6 millimeters long) in the skin between the nostrils. “Open rhinoplasty is a very common technique, where the skin is lifted upward like the hood on a car,” says Dr. Ronald Schuster, a Baltimore plastic surgeon, in a RealSelf Q&A about open vs. closed rhinoplasties. If you’re having a closed rhinoplasty, all incisions are placed on the inside of the nose, so there are no external scars.
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.
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.
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. 
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.
Case 16: A crooked and overprojected nose draws the eye away from other beautiful features. In this pretty young woman, you can see how rhinoplasty transforms her face. Even at this early 3-month point, we see that her nose is more feminine and no longer dominates her otherwise delicate features. And, at the same time, it is balanced and ethnically-appropriate.
Case 37: Achieving a beautiful, natural change in an already beautiful woman is one of the great challenges we love in rhinoplasty. In front view you see a beautifully defined, natural change that simply looks great. Then on profile and 3/4 views, you see an elegant change where the tip is deprojected (made smaller) but retains a beautiful, natural aesthetic- this is finesse rhinoplasty.
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