Case 29: Major concerns for this patient were widening of the tip with a marked lack of projection which made his nose feel flat and washed out. Nostril thickness and rounding was also something he wanted addressed. In this case, irradiated donor rib cartilage was used to project and support the tip along with alar base reduction removing a significant amount of nostril flare to create a natural tip and nostril contour that is ethnically appropriate. Fat transfer to the cheeks helps to balance out his flat mid-face to strengthen the cheek contour which can be seen nicely on the profile view.

When interviewing doctors, prospective patients should ask them about their approach to rhinoplasty. It is important to choose a doctor who addresses the airways, as well as the external structure of the nose. Even if a patient is undergoing the procedure for purely cosmetic reasons, the doctor should work to protect the nasal passages so that the patient can maintain normal breathing patterns.

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.
As with almost all forms of plastic surgery, there is a possibility for scarring following rhinoplasty. In closed rhinoplasty, all incisions are made inside the nostrils and will therefore not leave behind any visible scars. In open rhinoplasty, an additional incision made across the columella may leave a small scar behind. Fortunately, due to the size and location of the incision this scar is usually unnoticeable.
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.
Case 71: Tip and nostril width and overall nasal projection made the nose feel dominant for this young woman. Rhinoplasty involved making her whole nose smaller by deprojecting, refining the tip, and removing some nostril flare. At the same time, a nasal fracture and breathing concerns were addressed. Neck Liposuction also helped to define and re-balance her jawline to create the improved facial proportions that she desired.
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 results are usually permanent, aside from normal changes that come with the aging process. If you’re really not happy with your results or have breathing difficulties once your nose has healed, you may be a candidate for a revision rhinoplasty. In many cases, scar tissue is the main culprit. “The force of a scar is very strong,” says Dr. Miller. “It can pull a nose one way or another—push it in, pull it out, turn it.” When this happens, a surgeon has to go back in and tweak the work. 
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.
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 Rhinoplasty price includes a confidential consultation to discuss the concerns you have about your nose and consider the options that are available to you. Your photos are taken, and then the 3D VECTRA imaging system is used, allowing a 360-degree view so you are able to plan out the outcomes you would like to have and agree upon a surgical strategy with Dr. Torgerson. 
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