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.
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.

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.
The cost of the implants themselves ranges from about $1500-$4000. Usually when you ask a Doctor to give you a quote for this surgery they quote the entire price of the surgery (the implants, anesthesia, overhead, etc.) The cost for breast augmentation surgery is usually $7500-$9500 before taxes. If you would like a breast lift, this would be additional cost. Generally what causes the range in cost is the type of implant (saline, silicone, anatomical, etc.) Usually the number of cc's you decide upon will not effect the cost. There is financing usually available as well. Best of luck!
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 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. 

Breast implants are not lifetime devices and breast implantation may not be a one-time surgery. The most common complications for breast augmentation and reconstruction with MemoryGel® Implants include any reoperation, capsular contracture, and implant removal with or without replacement. The most common complications with MemoryShape® Implants for breast augmentation include reoperation for any reason, implant removal with or without replacement, and ptosis. The most common complications with MemoryShape® Implants for breast reconstruction include reoperation for any reason, implant removal with or without replacement, and capsular contracture. A lower risk of complication is rupture. The health consequences of a ruptured silicone gel breast implant have not been fully established. MRI screenings are recommended three years after initial implant surgery and then every two years after to detect silent rupture. The most common complications with MENTOR® Saline-filled Implants include reoperation, implant removal, capsular contracture, breast pain, and implant deflation.
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.
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.
Breast implants are not lifetime devices and breast implantation may not be a one-time surgery. The most common complications for breast augmentation and reconstruction with MemoryGel® Implants include any reoperation, capsular contracture, and implant removal with or without replacement. The most common complications with MemoryShape® Implants for breast augmentation include reoperation for any reason, implant removal with or without replacement, and ptosis. The most common complications with MemoryShape® Implants for breast reconstruction include reoperation for any reason, implant removal with or without replacement, and capsular contracture. A lower risk of complication is rupture. The health consequences of a ruptured silicone gel breast implant have not been fully established. MRI screenings are recommended three years after initial implant surgery and then every two years after to detect silent rupture. The most common complications with MENTOR® Saline-filled Implants include reoperation, implant removal, capsular contracture, breast pain, and implant deflation.
When estimating your cost for breast augmentation surgery, make sure to account for all of these fees. You should ask the surgeon directly if these are all the costs involved in your estimate. Since there are no set costs for any of these expenses, it is important to explore multiple options by meeting with several surgeons and getting estimates for not only their surgeon fees but also the additional surgical-related expenses.

A nose job can be done in a private surgical suite, an ambulatory surgical center or a hospital. A hospital is the most expensive setting, while a private surgical suite is the least expensive. Most people can have the work done in a private office or ambulatory setting, which is an outpatient procedure. Should you choose to stay overnight in a hospital and undergo an inpatient treatment, it would significantly increase the overall nose job cost.
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.

If you’re having what’s called an open rhinoplasty, the surgeon will make an incision (about 6 millimeters long) in the skin between the nostrils. “Open rhinoplasty is a very common technique, where the skin is lifted upward like the hood on a car,” says Dr. Ronald Schuster, a Baltimore plastic surgeon, in a RealSelf Q&A about open vs. closed rhinoplasties. If you’re having a closed rhinoplasty, all incisions are placed on the inside of the nose, so there are no external scars.


Patients who are unhappy with their previous nose job results are candidates for secondary rhinoplasty. Whether the nose is deemed too small, too large, or improperly shaped, a skilled surgeon may be able to correct the problem. Patients who experience breathing difficulties following rhinoplasty may also opt to undergo a second procedure. Factors influencing candidacy for revision rhinoplasty include:

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. 
Although everyone heals at a different rate, most people will have very few signs of surgery at two weeks after rhinoplasty and feel comfortable returning to work. At this time most of the bruising has gone but there may be still some dark circles under the eyes that can be covered up with make up. There is usually some swelling on the tip of the nose and along the sides of the bridge. This will mostly be obvious to you and your surgeon but not the average person in the public.
If a patient has suffered an injury to the nose, he or she may benefit from post-traumatic rhinoplasty. This procedure can address both appearance and functionality. Doctors may use this procedure to straighten the nose and correct the nasal septum. Often, post-traumatic patients have suffered a broken nose. In these cases, a doctor may have to re-fracture the nose and re-set it to achieve the desired results. A doctor can usually set a simple broken nose within 10 days of the fracture. However, if a patient has suffered a serious nose injury, he or she may have to wait several months before undergoing extensive surgery.
6)What else is included with your surgery?  Some are bare bones deals - you get your implants and good bye, while others include a comprehensive pre-surgical assessment, and a thorough post-surgical follow up.  (we've heard from other patients about their friends getting their BA elsewhere, and after the surgery they saw their surgeon only at one week after surgery and never again!  We don't do that ... at our clinic you are welcome to come back and see us as often as needed, and we have a schedule of follow up visits for a full year after your surgery to ensure you get the best results possible.)

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.
If the rhinoplasty is necessary to improve breathing, rather than for aesthetic purposes, there is a possibility that the repair may be covered by insurance. An obstructed airway is usually caused by a deviated septum, and operating is necessary to restore normal air flow. Physicians will refer patients with this problem to facial plastic surgeons, who are able to determine the impairment and who will receive authorization by the insurance company to operate.
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.
"Many times, the cost of rhinoplasty or other surgery in New York City would be three times the price as in a smaller town, but it is not three times better necessarily," Dr. Park said. "At the same time, I would warn patients to beware of a physician in a small town that costs a fraction of what an average rhinoplasty would cost. In general, when a surgeon is throwing in discounts, I would be very wary."
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.
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