Most experts agree that Botox can also be a preventative measure for some younger clients, ‘It preserves the skin and stops lines developing,’ explains Spyrou. ‘Botox softens and temporarily freezes the muscles, which means the treated area will stay flat. If you can’t physically frown, then over time, the line will smooth out.’ That being said, there's a lack information about the long term effects of starting botox at a younger age. "The long term safety data in these treatments is usually focussed on older individuals." Says Dr. Justine Hextall, Consultant Dermatologist on behalf of The Harley Medical Group. So as with most cosmetic procedures, there are risks.
Case 78: A combination approach was used here to create a really meaningful but completely natural transformation. Otoplasty made prominent ears all but disappear from the field of view and no longer distract or draw attention. At the same time, rhinoplasty, chin augmentation, and neck liposuction accomplished were able to remove a nasal hump and overprojection while improving chin and neck laxity to achieve a nice overall balance.
Rhinoplasty surgery is one of the most common plastic surgeries performed each year. This procedure allows surgeons to make a number of changes to the structure of the nose, drastically altering a patient's appearance. However, as with any other surgical procedure, it is important for individuals to understand all possible outcomes and set realistic expectations before undergoing rhinoplasty.

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.
Case 44: One of the hardest things to accomplish in a nose job is giving a person a smaller version of the same nose. In Los Angeles, where small differences can mean everything, doing Finesse Rhinoplasty is common. Even at 6 months, you can see that, on profile, this patient’s tip is less projected but he still has a strong masculine profile. On base view, you will also notice the deprojection and the fact that alar base reduction can be done with no visible scars and maintenance of the natural nostril curve.
‘You’ll start to see an effect after 3-5 days’, instructs cosmetic doctor Rita Rakus, ‘however it may take two weeks for maximum results to kick in’. For me, my forehead had less movement after day three, but it wasn't until a full week after the treatment that it felt completely immobile. It’s definitely a strange sensation as you go to lift your brows…but nothing moves.
Dr. Miller says it’s also important for patients to have realistic expectations. “It’s not a good idea to take a wide, thick nose and turn it into one that’s thin and tiny,” he says. “But if the steps are done properly, we can make the desired changes.” Thick nasal skin that makes it challenging to refine the nasal tip needs to be thinned out, for example. It’s important to find a board-certified facial plastic surgeon who specializes in ethnic rhinoplasties. 
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.

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.
Tell your doctor if you have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (tell your doctor exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-like products or blood thinners.
Tell your doctor if you have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (tell your doctor exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-like products or blood thinners.

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.


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. 
In recent years, medical tourism, or going outside the U.S. for a surgery or procedure, has become more popular. Patients go to other countries to have rhinoplasty and other surgery performed at a lower cost. While several other countries, such as South Korea, Columbia, and Italy, may have surgeons willing to perform rhinoplasty at a low cost, the quality and safety standards may not be as closely regulated as they are in the U.S.
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 92: This procedure was all about correction of a droopy twisted tip. This patient was especially bothered by the tip’s tendency to drop and spread when she smiled, with a twist that made one nostril look higher than the other. After surgery, her nose is about as straight and symmetric as can be and the straighter bridge line makes her look younger.
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.
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