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.
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).
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.
For detailed indications, contraindications, warnings, and precautions associated with the use of all MENTOR® Implantable Devices, which include MENTOR® Saline-filled Implants, MemoryGel® Implants, MemoryShape® Implants, ARTOURA™ Expanders, and CONTOUR PROFILE® Expanders, please refer to the Instructions for Use (IFU) provided with each product or visit www.mentorwwllc.com.
Doctors realize that most rhinoplasty patients are not eligible for insurance coverage. For this reason, many surgeons offer in-house financing options. With approved credit, patients may be eligible for low-interest or fixed-interest repayment plans. Additionally, many doctors offer significant discounts when patients pay for their procedures in full prior to treatment. Most cosmetic surgery practices accept cash, check, and all major credit cards.
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.
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. 

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.
Naturally, patients should choose a doctor who has a good reputation for success. Individuals should ask friends, family, and general practitioners for recommendations. Additionally, all state medical boards are required to make a doctor's information public. Patients may access these records to look for any past lawsuits or infractions. In many areas, these records are available online, but in some states, they can only be accessed through the mail. 

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:
For my patients, I also provide a post-operative packet. This includes arnica and other ointments, gauze and tape, an ice pack, and nasal decongestant spray. If your surgeon does not provide these items to you before or after your surgery, they are all helpful during the healing process. I encourage my patients to get anti-nausea medication for the first few days following surgery as well.
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.
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.

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.
Tobacco use slows blood flow throughout the body. Because oxygen cannot reach the incision sites very quickly, smokers may face a longer recovery and a higher risk of infection and unfavorable scarring. Although smokers are not automatically disqualified from rhinoplasty, they should quit the habit for at least two weeks before and two weeks after the surgery.

Make sure the surgeon you choose carefully analyzes both the outside and inside of your nose and presents you with a clear plan for how he intends to approach your surgery. Also, consider the quality of your communication and rapport with your surgeon. These qualities will help you choose a surgeon who truly listens and who takes your concerns seriously.


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 72: This patient had sustained a nasal fracture that caused a significant deviation of her nose. The fracture was corrected along with a septoplasty to improve breathing. Loss of tip support after the injury made her hump look more prominent and her tip felt more droopy. The bump was smoothened and her tip angulation restored to create the softer, more feminine profile she wanted. At the same time, fat transfer to the cheek and under eye area and subtle neck liposuction substantially improved the flat cheek and mid-face contour that previously made her feel hollowed and tired looking without makeup.
Case 69: This patient was bothered by his prominent ears and a sense of width to his nose that made it feel bulky and unrefined in his view. While still preserving his ethnic identity, he was able to achieve a meaningful improvement in nasal balance. Bringing his ears back into the vertical plane helped to make them less noticeable and remove them as a source of focus for him.
Some people opt for a temporary nonsurgical nose job—also called a liquid rhinoplasty—with hyaluronic=acid-based injectable fillers, like Voluma or Restylane Lyft. This minimally invasive procedure can camouflage bumps, create more symmetry, or lift and build up the tip of your nose. This approach has its limitations though. “If you have a large nose, it’s not going to get any smaller with fillers,” says Dr. Miller, though changes in proportions can sometimes make it appear smaller. It also can’t fix a crooked nose.
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