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.
Dr. Miller says it’s also important for patients to have realistic expectations. “It’s not a good idea to take a wide, thick nose and turn it into one that’s thin and tiny,” he says. “But if the steps are done properly, we can make the desired changes.” Thick nasal skin that makes it challenging to refine the nasal tip needs to be thinned out, for example. It’s important to find a board-certified facial plastic surgeon who specializes in ethnic rhinoplasties. 
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).

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. 
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.
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.
Case 94: This patient was seeing the early signs of facial aging including loss of skin tone and elasticity, early jowling, and heaviness under the chin. A lower facelift along with fat transfer to the under eye and cheek area substantially improved the contour and even apparent texture of her skin, making her look noticeably younger. In addition, the overall effect was completed with a rhinoplasty focused on reducing the width, rounding, and thickness of her tip and nostrils which is a challenge in the setting of thick skin.
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.
Case 3: A curvature and droopy tip brings undue focus to this young man’s nose. Although there is still some swelling in these early post-operative photos, we can already see a nose that is now straight, has a smooth profile and no longer droops. A sense of length is preserved to match his oval face. More than that, because of these positive changes, he also looks younger.
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.
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.
When rhinoplasty is performed primarily for cosmetic purposes, it is rarely covered by insurance. However, insurance companies will often pay for procedures to correct a deviated septum or other breathing issues. A doctor's administrative staff can help patients determine whether they are eligible for insurance coverage. In many cases, they will even file the claim and handle any other paperwork.

As with any injection, injury can occur. An injection could result in localized infection, pain, inflammation, tenderness, swelling, bleeding, bruising, etc. BOTOX may cause asthenia (lack of strength), muscle weakness, somnolence (drowsiness), dizziness and visual disturbance, which could affect driving and the operation of machinery. If there is a reaction, further injections of BOTOX should be discontinued. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech or respiratory disorders arise.
Case 43: Rhinoplasty in this pretty professional woman was all about removing the bump she had hated for years and correcting the tip droop and asymmetry that had worsened with age. Relatively small changes here have created a real sense of refinement while maintaining her long, elegant profile. A lower face and neck lift along with facial fat transfer helped to round out the enhancements in her already beautiful appearance.
Revision (secondary) rhinoplasty is a cosmetic surgery that is performed when a patient is not satisfied with the outcome of his or her initial procedure. In some cases, patients may be unhappy with the appearance of their noses, while others may experience functional difficulties after surgery. Additionally, a patient may need a secondary procedure if he or she suffers traumatic injury following the first nose reshaping surgery.

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.


Rhinoplasties, like other surgeries, especially cosmetic ones, can cost vastly different amounts. The price of any surgery varies with the complexity of the procedure, the expertise and reputation of the surgeon, and the geographic region in which the surgery is to be performed. Prices for the surgery can range anywhere from $3,000 to $15,000. Typically, whatever the fee is, the cost of rhinoplasty does not include anesthesia, operating room facilities, or other related expenses.


This 37 year old female patient was troubled by the furrows that were appearing between her brows. These furrows are one of the unavoidable signs of aging, but we were able to roll back the clock a little with a quick application of Botox. We have more Botox ‘forehead lines’ before-and-after photos available at our clinic if you’re interested. You can also schedule your consultation for a Botox treatment, here.
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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 46: A hump and hanging tip cause the nose to dominate otherwise beautiful features in this young woman. In this case, a tip lift, hump reduction, and tip refinement preserves some of her rounded appearance, very naturally enhancing her pretty eyes. On the bottom view, we see a good example of how open rhinoplasty incisions should heal virtually undetectably when done with care.


Because TCC is a private clinic, we do not perform septoplasty. However, we are able to perform septorhinoplasty, which would increase your overall rhinoplasty cost. In this case, because the surgery would be intended to correct the function of the nose rather than just its aesthetic appearance, it may be covered by your health insurance. Ask your patient consultant whether this situation may apply to you.
As you probably already know, breast augmentation costs vary depending on the person, the procedure, and the clinic. There's no such thing as "one-size-fits-all" breast augmentation. In addition, the prices clinics charge are usually based on factors such as implant type, the equipment they use, the clinic's accreditation, the skill of the surgical staff, and the surgeon's level of experience.
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.

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Revision rhinoplasty is similar to primary rhinoplasty, and it can be performed as an "open" or "closed" procedure. In closed rhinoplasty, the surgical incisions are made inside the nose to eliminate the appearance of scarring. With open rhinoplasty, an additional incision is made across the columella. While this leaves a small scar, it gives the surgeon more access to the nasal tissue and bone. The goals of your rhinoplasty revision will dictate the type of surgery you receive.
Case 78: A combination approach was used here to create a really meaningful but completely natural transformation. Otoplasty made prominent ears all but disappear from the field of view and no longer distract or draw attention. At the same time, rhinoplasty, chin augmentation, and neck liposuction accomplished were able to remove a nasal hump and overprojection while improving chin and neck laxity to achieve a nice overall balance.
Rhinoplasties, like other surgeries, especially cosmetic ones, can cost vastly different amounts. The price of any surgery varies with the complexity of the procedure, the expertise and reputation of the surgeon, and the geographic region in which the surgery is to be performed. Prices for the surgery can range anywhere from $3,000 to $15,000. Typically, whatever the fee is, the cost of rhinoplasty does not include anesthesia, operating room facilities, or other related expenses.

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.
When you choose a surgeon with his/her relevant specialty and academic authenticity, it becomes more difficult. Even academic education passed in the best universities does not provide guarantees of surgeon’s skill. In fact, A and B points are necessary conditions but not sufficient. In our country, little attention is paid to scientific know-how of students before selection, and this results in the graduation of surgeons with higher scientific level but lower surgery skill and art. Now, how can we access to this information?!
One investigation from 2003 tried to decide if Botox infusions under and around the eyes could diminish the presence of wrinkles in these regions. Nineteen female members gotten infusions. The individuals who had them in the lower eyelids and crow’s feet territory will probably report positive outcomes than the individuals who just gotten infusions in their lower eyelids.
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. 
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 87: This young woman had broken her nose and was noticeably crooked with poor nasal breathing. In addition, she disliked her nasal hump and length. She preferred an aesthetic with a slight supra tip break to soften her profile. Beyond straightening and improving her breathing, you can see how we were able to remove the nasal hump and lift her tip to transform her look while still looking completely natural.


We think you shouldn’t have to wait to look better, and more importantly, feel better about yourself. To help our patients afford rhinoplasty, we offer several financing options. When you apply, we’ll take a look at your credit history to determine your qualification and financing amount. Upon approval, you can book a date for your procedure. Afterward, you’ll make monthly payments. Financing can help you get where you want to be sooner rather than later.
Case 12: One of the things that we love about rhinoplasty is that we can combine dramatic changes such as straightening this patient’s nasal twist, and at the same time create some subtle enhancements such as refining and slightly deprojecting the tip while reducing the sense of columellar show. At 6 months, her nose now balances with her face and really brings out her beautiful eyes.
Like facelift surgery, brow lift surgery eliminates sagging skin and reduces deep creases. However, brow lifts specifically target the forehead and the area between the eyebrows. The doctor creates an incision along the hairline or the crown of the head. Then he or she lifts the underlying muscles to reduce frown lines, vertical creases, sagging eyebrows, and hooded brows.
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. 
We think you shouldn’t have to wait to look better, and more importantly, feel better about yourself. To help our patients afford rhinoplasty, we offer several financing options. When you apply, we’ll take a look at your credit history to determine your qualification and financing amount. Upon approval, you can book a date for your procedure. Afterward, you’ll make monthly payments. Financing can help you get where you want to be sooner rather than later.
The most exciting part of the rhinoplasty is the use of our state-of-the-art operating facility! Our hand-picked staff want to give you the best experience possible, and they do everything to ensure that your needs are met before and after surgery. You will enjoy the comfort of our state-of-the-art private surgery centre in Yorkville, downtown Toronto, where you are treated like an individual rather than a number. Our fee includes anaesthetics, our qualified operating team, a recovery nurse and most importantly, the expertise of our Facial Plastic specialist, Dr. Cory Torgerson. After care is also included in the rhinoplasty fee. The doctor releases his private cell phone number so he can be contacted at any time if concerns arise. And finally, follow-up appointments to observe the healing process are also included.
The geographic location of the surgeon's practice can greatly affect the cost of rhinoplasty. More affluent cities and neighborhoods, such as Manhattan and Los Angeles, are plastic surgery hubs where some of the best surgeons in the world practice. Meanwhile, these areas also have a higher cost of living, which means higher overhead costs (rent, staff wages, utilities), and that translates to a higher overall price of rhinoplasty.
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. 
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.
The closed vs. open rhinoplasty technique concerns only how the surgeon gets inside the nose to make the required changes, not what’s accomplished with the rhinoplasty procedure itself. Reshaping your nose may include breaking and removing bone and cartilage. If cartilage needs to be added, say, to rebuild the tip of the nose, it’s often taken from the septum, the middle portion of the nose—a technique called a cartilage graft. Cartilage may also be taken from other areas of your body, such as your ear. In some cases, a synthetic material, like a silicone implant, is used; but studies have shown that there may be more complications with synthetics. Cartilage grafts, nasal-bone osteotomies (removal of parts of the bone), dorsal-hump removal, and suture techniques applied to the nasal tip cartilages can all be performed with either the closed- or open-approach rhinoplasty.
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