The patient receiving the Botox injections must stop taking blood-thinning medication at least a week prior to Botox injections. Avoid Aspirin, Advil, Excedrin, Vitamin E supplements and natural sources such as Fish oil, Ginseng and Gingko Bilbao. This helps prevent any bruising after the Botox treatment. All pain medications are to be avoided except Tylenol.
Case 4: Some might think that this patient had had previous rhinoplasty with tip collapse, but she did not. Occasionally, the shape of the tip cartilages is very vertically-oriented, causing a deep groove in the nostril. She felt this, along with her marked tip crookedness, drew unwanted attention to her nose. Now, her nose is smaller, smoother, more defined, and just blends with the rest of her face.

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.
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.
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.
To apply for insurance coverage for a functional rhinoplasty, your surgeon can perform one of several tests. A CT scan shows irregularities within the nose that are not visible to the naked eye. An acoustic rhinometry is a test that maps the inside of a patient's nose. A rhinomanometry tests the level of airflow within the nostrils. In some cases, insurance companies require that patients show that they have attempted to treat nasal obstruction with other treatments. These may include antihistamines, allergy desensitizing injections, and steroid spray.
5) What kind of anesthesia will you be getting and who will be doing it?  Like surgeons, different anesthetists charge different fees, and use different anesthetic agents.  At the Toronto Cosmetic Surgery Institute our anesthetist come with probably the most extensive cosmetic surgery experience in Toronto.  And the medications we use are more expensive than others, but we use them not to have an excuse to charge you more, but to keep you more comfortable, in less pain, and minimal to no nausea and vomiting after surgery.

Ambulatory surgical centers are more expensive than private offices. These venues are owned by a third party, and provide everything your surgeon needs to safely perform rhinoplasty and other cosmetic surgery procedures. They typically charge by the hour. Ambulatory surgical center fees are usually around $3,000 or more for a single rhinoplasty procedure.
5) What kind of anesthesia will you be getting and who will be doing it?  Like surgeons, different anesthetists charge different fees, and use different anesthetic agents.  At the Toronto Cosmetic Surgery Institute our anesthetist come with probably the most extensive cosmetic surgery experience in Toronto.  And the medications we use are more expensive than others, but we use them not to have an excuse to charge you more, but to keep you more comfortable, in less pain, and minimal to no nausea and vomiting after surgery.
Both anesthesiologists and registered nurse anesthetists can administer anesthesia. An anesthesiologist is a specially trained physician who will administer anesthesia and monitor your vital signs during surgery. A registered nurse anesthetist has specialized training to do the same.  However, while a registered nurse's services can cost about $300 per hour, an anesthesiologist's services can cost closer to $500 per hour.
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).
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.
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...
Doctors have recently developed a non-surgical nose job, using dermal fillers to enhance the shape of the nose in one 15-minute treatment. By injecting fillers, such as Radiesse® or Restylane®, the doctor can correct minor asymmetry and make other changes. However, if you are looking for more dramatic results, or if you require reduction rhinoplasty, surgery is the only option. Additionally, a non-surgical nose job cannot treat a deviated septum or other breathing issues. While nasal strips can enhance your breathing, surgery is the only way to permanently treat these conditions.
MENTOR® MemoryGel® Breast Implants, MENTOR® MemoryShape® Breast Implants, and MENTOR® Saline-filled Breast Implants are indicated for breast augmentation in women (at least 22 years old for MemoryGel® Implants and MemoryShape® Implants, and 18 years old for Saline Implants) or for breast reconstruction. Breast implant surgery should not be performed in women with active infection anywhere in their body, with existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions, or who are currently pregnant or nursing.

Case 21: For our patients who are in image-centered occupations such as modeling or acting, nasal refinements often focus on small changes that will enhance the overall look and remove subtle cues about the nose that preoccupy or distract the eye. This successful model had a look that really worked for her but had always felt that her tip and nostrils were too wide, flared, and slightly droopy. Creation of a slightly narrower and more structured tip draws unwanted attention away from her nose and, instead, enhances her overall look.


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. 
Rhinoplasty, a surgical procedure commonly known as a “nose job,” has become much more common in recent years. There are several reasons for this. For one thing, increasing media use focuses wide attention on the successful surgeries of celebrities (and even ordinary individuals). For another, the culture as a whole has increasingly accepted various means of improving and enhancing one’s appearance. The third, and perhaps most important, reason for the popularity of rhinoplasty is the astonishing improvements that have been made in the operation itself.

Every surgeon has determined what they feel is appropriate for their expertise and time performing this procedure and taking care of you following the procedure. But what is most important is that after you have done this screening and met with your potential surgeon that YOU feel confident in your choice. You have to stay in budget, but there are MANY other factors to consider! Good luck to you!

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 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.
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