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.
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.
The most common reason for patients to undergo rhinoplasty surgery is to improve the appearance of their nose. Many individuals feel that the size or shape does not match the rest of their facial features, and they choose surgery to bring a harmonious balance to the face. During rhinoplasty, changes can be made to the bridge, tip, and nostrils, making nose reshaping a versatile procedure. Choosing a qualified surgeon to perform rhinoplasty surgery will ensure that patients receive the most beneficial outcome. Among the aesthetic rhinoplasty benefits are:
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.
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.
For me, the main area of concern is my forehead, which I’m told by all the greatest in injectables, to be the most common for those under thirty. After too many holiday sunburns, and recognising that I speak with very expressive eyebrows, the fine faint lines horizontally across my forehead have become much more prominent. So, in the name of beauty journalism I decided to give botox a try, here's what I learnt...
Rhinoplasty can be performed in one of three places: private surgical suites, ambulatory surgical centers, or hospitals. You should speak with your surgeon and make certain that their chosen venue has been accredited by an organization such as the American Association for Accreditation of Ambulatory Surgical Facilities (AAAA), the Accreditation Association for Ambulatory Health Care (AAAHC), or the Joint Commission for Accreditation of Healthcare Organizations (JCAHO).
Underarms are the most common and easiest place to administer Botox. Often a simple solution is put on the skin to see the exact area a person sweats from and then Botox is injected with tiny needles just under the skin.  It is prepared on a way that some anesthetic is mixed with the Botox to make it a relatively pain-free treatment.  It takes only minutes to complete.

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.

After surgery, patients should be prepared for the cost of any pain medication they will take during recovery. These costs are not typically included in the overall cost of surgery. At my practice, we provide homeopathic medications as part of our total surgical package. Your surgeon can explain to you any prescription or homeopathic medications you may be prescribed and discuss their cost.
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.
After the doctor determines that a patient is physically qualified for surgery, he or she asks about the aesthetic or health-related objectives. When seeking rhinoplasty for cosmetic reasons, patients may want to bring in pictures of what they want their noses to look like. An exact replication may not be possible. However, these images will help the doctor create a treatment plan in keeping with the patient's cosmetic goals.
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!
"Sometimes, a good reputation is well deserved, and sometimes it's merely hype and marketing," Dr. Naderi said. "There are reality show plastic surgeons who charge high fees, for example, based on their television exposure and publicity. Then, there are well-known plastic surgeons in the field who focus mainly on nose surgery and are true specialists."
When Botox is placed near the sweat glands it signals the sweat to stop.  It can take a few days or more to work but the results are dramatic. On average, there is over 80% decrease of sweat production in that area that lasts on average 7 months. Remarkably, up to a third of patients can go 1 year before they return for more. Therefore, you are treated once or maximally twice per year and don’t have to worry about constantly treating the area.
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.)

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.
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).
Rhinoplasty is a technical term for surgery that reshapes the nose. Dr. Rival performs rhinoplasty, also called nose surgery, in Toronto to address aesthetic concerns, for breathing correction or to correct a deformity following facial trauma. A septoplasty is a term used to describe the procedure where the midline partition between the 2 sides of the nose is straightened. This is usually done to improve nasal breathing but may also be necessary to straighten the external appearance of the nose.
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.
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. 

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.
Dr. Richard Rival, a rhinoplasty surgeon in Toronto, has both certifications. While board certification is an essential prerequisite, make sure your surgeon has extensive experience performing the procedure and does so on a regular basis. Ask to see photos of previous patients. While these photos will likely show only the "best results," you will able to determine whether the surgeon is able to produce the improvements you want by paying attention to cases in the photo gallery that are similar to yours.
Case 44: One of the hardest things to accomplish in a nose job is giving a person a smaller version of the same nose. In Los Angeles, where small differences can mean everything, doing Finesse Rhinoplasty is common. Even at 6 months, you can see that, on profile, this patient’s tip is less projected but he still has a strong masculine profile. On base view, you will also notice the deprojection and the fact that alar base reduction can be done with no visible scars and maintenance of the natural nostril curve.
The complexity of the surgery itself is one factor that people tend to forget when considering the overall cost of a good nose job. Depending on whether you have thick or thin skin, multiple injuries to the nose or severe nasal deviations, the complexity of the surgery required may vary, and so too will the cost. The more complex the surgery, the more expensive it will be. When planning your finances, be sure remember to factor in time spent off work and travel costs as well.
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