Case 38: This beautiful young lady is an early 6 month example of a finesse rhinoplasty. On front view you can see the bridge is narrower and the sense of hang is improved. On profile, the tip looks undone, natural and less projected with correction of the slight hanging columella. The result is a beautiful, natural look that corrects the issues but leaves her looking totally natural and undone. 

However, if a patient underwent surgery in another country, but experiences post-operative complications, he or she will need to pay to travel back to the same destination if they wish to have the same doctor oversee any revisions. Revision surgery performed by a different surgeon is extremely difficult, and thus more expensive. In fact, it can cost 50 percent more than the original surgery. Therefore, it can actually be far more economical to pay for a surgery within the U.S.
One of the main things to keep in mind regarding medical tourism is how difficult it may be to see or even contact your doctor after surgery. Follow-up appointments are extremely important. When surgery is performed internationally, patients either miss post-operative appointments or have to stay in the area for an extended period of time. When you have surgery closer to home, you can more easily attend these appointments and visit your surgeon if any other problems or concerns arise. Many surgeons like myself will revise their own work at no additional charge except for anesthesia fees or surgical venue fees.
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.
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).
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.
Meeting with multiple prospective surgeons is also a great way to make your choice. Make sure you are comfortable speaking to the surgeon, and make sure he or she asks you plenty of questions, and does not rush you through any part of the consultation. After you have fully described your goals, the surgeon should provide you with informative, thoroughly explained options.
There’s definitely no denying, the B word has definitely been a talking point of late, not just in the media, but within my close circle of friends too. Would you? Wouldn’t you? Have you? Has she? I promise it’s not as ‘Real Housewives of Cheshire’ as it sounds... But whilst I'm only 28, the reality is that the constant stream of late nights, binge drinking (sorry Mum) and falling asleep with a full face of makeup on, are all starting to show their effects.
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.
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.
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.
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.

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 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.
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.
Rhinoplasty is a highly personal procedure that can affect a person's mental well-being, as well as his or her appearance. Therefore, it is vital that patients choose a surgeon with whom they feel comfortable. They should select a doctor who truly listens to their concerns, answers their questions, and creates a treatment plan that will address their specific goals. Patients should never choose someone who makes unrealistic promises or pressures them to undergo more surgery than they actually want.
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.

Case 34: Hispanic Rhinoplasty in this patient meant removal of a high dorsal bump on profile and correction of a droopy-appearing tip. On front view, there is correction of a left nasal bone fracture and refinement of the nasal tip. All of this was done while still maintaining her unique individuality and while bearing in mind the various challenges Rhinoplasty in Latino patients present- thicker skin and softer cartilage.


The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.

A revision rhinoplasty is a complicated surgery, because the surgeon now has to contend with thick scar tissue—which makes it difficult to raise the skin and soft tissue off the cartilage. “Plus, we often need to reconstruct part of the nose, so we need to take cartilage from other sources,” says Dr. Miller. Surgeons say that the minimum amount of time to wait before you can do revision rhinoplasty, even if there is an obvious problem, is a full year. 


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.
It is sometimes possible to have additional plastic surgery done at the same time while you are already asleep. It is not uncommon for Dr. Rival to perform lip enhancement, blepharoplasty (eyelift), otoplasty (ear setback) or even a facelift if the rhinoplasty is a limited procedure. Combined body plastic surgery procedures can sometimes also be arranged simultaneously. Overall each case must be assessed individually in this regard. For information on other facial plastic surgery procedures performed by Dr. Rival please see our main site www.rivalcosmeticsurgery.com .
So what is the ideal age for botox? ‘There is no recommended age’, Wallace says, and Victoria Spyrou, the injectables expert at EF MediSpa agrees, ‘The recommended age differs because everyone’s muscles present differently. If someone at the age of 21 has visible dynamic lines that are causing a problem, then I will treat that person, however, if another 21-year-old comes in without any visible lines – I would decline to treat them.’

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.


Rhinoplasty is a highly personal procedure that can affect a person's mental well-being, as well as his or her appearance. Therefore, it is vital that patients choose a surgeon with whom they feel comfortable. They should select a doctor who truly listens to their concerns, answers their questions, and creates a treatment plan that will address their specific goals. Patients should never choose someone who makes unrealistic promises or pressures them to undergo more surgery than they actually want.
Typically, at our clinic, rhinoplasty costs $8,500 ($7,500 + $1,000 for general anesthesia) plus tax. The total cost may vary based on your body and desired results, and whether you have any simultaneous procedures. In addition, clinic prices can vary based on factors such as the equipment they use, the clinic's accreditation, the surgical staff's skill levels, and the surgeon's experience.
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.
Patients may require reconstructive rhinoplasty if they have lost all or part of their noses to an accident, skin cancer, or another serious illness. During the treatment, a surgeon rebuilds the nose using skin grafts, flap techniques, and other advanced methods. Due to the complex nature of this procedure, patients may require multiple surgeries over a period of several months. Additionally, reconstructive rhinoplasty is a specialized procedure, and patients should look for surgeons who have extensive experience in this area.
The Ministry of Health will usually cover the portion of the procedure that is done to correct a breathing problem (septoplasty or turbinate reduction). Sometimes the Ministry of Health will cover septorhinoplasty to straighten a deviated nose when this occurs as the result of trauma or congenital birth anomaly. This requires prior approval from the ministry. Private insurance plans generally do not cover cosmetic surgery.

Case 61: The concerns in this case were crookedness and a significant breathing issue due to a severely deviated septum. She also felt her nose was over-projected and a little too big for her face. Here we can see resolution of her crooked septum on base view. The tip has been defined and de-projected and the bump brought down to create a naturally pretty and more balanced contour.

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.


You are a good candidate for rhinoplasty if you are in good general health. You have been bothered by the appearance of your nose for some time (years). You are generally happy with yourself but just don't like your nose. You are doing the procedure for yourself, not because of outside pressure from friends or family. You expect significant improvement but not perfection.
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. 
Arm LiftBody ContouringBody LiftBotulinum ToxinBreast AugmentationBreast Implant Removal & ExchangeBreast LiftBreast ReconstructionBreast ReductionBrow LiftButtock Lift with AugmentationChin AugmentationCleft Lip and PalateDermal FillersEar SurgeryEyelid SurgeryFaceliftGynecomastia SurgeryHair TransplantLip AugmentationLiposuctionRhinoplastyThigh LiftTummy Tuck
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