Rhinoplasty 101

DermaMatrix : Best Graft Material for Rhinoplasty

2010-02-27T07:26:00.000-08:00

DermaMatrix Acellular Dermis may provide a new option in rhinoplasty technology for surgeons. DermaMatrix, which was introduced to the surgical market in 2006, is made from acellular dermis, an innovative technological breakthrough substance which has been used as an alternative to Alloderm in rhinoplasty by Denver plastic surgeon Dr. Jeffrey Raval. Dr. Raval who presented the technique at the January 30, 2010 Annual Meeting of the American Academy of Cosmetic Surgery (AACS) in Orlando Florida.

Dr. Raval reports that “rhinoplasty poses a number of challenges- the ideal graft material being one of them.” Traditionally, Alloderm has been used as the grafting material in rhinoplasty surgeries. Unfortunately, despite its widespread use, Dr. Raval believes that Alloderm has not proven to be the “ideal grafting material” for several reasons. First, before being used, it has a short shelf life, and must be refrigerated. When used in a surgery, it requires a long rehydration time and displays reabsorption characteristics. DermaMatrix is derived from donated skin where the cells are removed to minimize inflammation or rejection at the surgical site and the acellular dermis is then freeze-dried for preservation.

DermaMatrix provides a better alternative. Dr. Raval reports that it rehydrates quickly, is uniformly soft and pliable after being rehydrated, passes the USP standard for sterility, is bacterially inactivated, has a three year shelf life at room temperature, has greater tensile strength, has a 90 percent consistency of thickness, is easier to surgically manipulate, and displays less reabsorption characteristics than Alloderm. These many advantages make it both easier to use and better for patients and can help the effects of rhinoplasty last longer.

Dr. Raval, who presented DermaMatrix at AACS, is a double board certified plastic surgeon and is regarded as the premiere revision rhinoplasty surgeon throughout the Western states. In addition to performing rhinoplasty revisions, which are often regarded as more complex than original rhinoplasty surgery due to the presence of scar tissue, Dr. Raval also treats the head and neck and performs both non-invasive and surgical procedures.

Source : American Health and Beauty

London Welbeck Hospital Offers Rhinoplasty

2010-01-25T05:22:00.000-08:00

Reputed and well known cosmetic surgery hospital, London Welbeck Hospital is now offering great offers on cosmetic surgery. You can now get Breast Augmentation or Rhinoplasty done from only £3299. This offer is currently being offered as part of their 'New year - New You' campaign.

The purpose of the breast implant is to push your own breast tissue up and
outwards, resulting in a natural look, feel and behaviour of the breast. Implants come in various shapes, sizes and materials. The breast augmentation surgeon will discuss with you the most suitable shape and size for you. It is important to take into consideration your personal expectations as well as your current breast and body shape.

The London Welbeck Hospital in Welbeck Street, City of Westminster, London was established in the early 20th century and now specialises in cosmetic surgery.
Over the years, London Welbeck Hospital has had many clients returning happily with their service. Situated in the heart of the London medical scene, this is a welcoming environment, where our dedicated staff are friendly, professional and committed to providing an excellent standard of care for patients, from the moment they walk in at the reception, to the moment they leave us.

Registered with The Healthcare Commission, we work with some of the most prominent surgeons in the UK. Our surgeons are not only highly qualified but also vastly experienced and innovative.

To find out more or to contact London Welbeck Hospital, please visit their website at www.londonwelbeckhospital.co.uk

London Welbeck Hospital offers complete cosmetic surgery treatments including breast augmentation, eyelid surgery, ear surgery, breast implants and many other cosmetic treatments.

Heidi Montag admits she's addicted to plastic surgery

2010-01-15T04:46:00.000-08:00

Heidi Montag, star of MTV's The Hills but best known for an apparent starvation for attention, has confessed that she is addicted to plastic surgery. This is bad enough when we're talking about aging starlets, but Heidi was a beautiful girl of 21 when she had her first surgeries, a breast augmentation to a C cup and rhinoplasty. Her recent surgeries, at the age of 23, included liposuction and buttocks augmentation, an "upgrade" for her "boob job," a chin reduction, pinning back her ears. And yet she says, "I'm just starting," she says. "Let's just say there's a lot of maintenance. Nobody ages perfectly, so I plan to keep using surgery to make me as perfect as I can be. Because, for me, the surgery is always so rewarding."

I have been saying that Saturn in Libra will test our standards of beauty, but I couldn't have anticipated this. In a society where teens are given cosmetic surgeries for graduation gifts, reality shows portray ordinary people receiving extreme makeovers, and an MTV show called "I Want a Famous Face" turns unique individuals into clones of their favorite movie star - Saturn arrives in Libra not a moment too soon.

But the question is, will teens look at Heidi's makeover from beautiful girl to plastic sex toy and be horrified, or will they want to emulate her? In any case, the discussion over how far is too far has certainly begun.

Source : blog.beliefnet.com

Rhinoplasty News : Injectables for Post Surgical Operations

2010-01-07T05:58:00.000-08:00

Rhinoplasty, sometimes referred to as a “nose job,” can improve the shape, size and general appearance of the nose. However, imperfections following rhinoplasty are common, which is why some surgeons have turned to injectable fillers as a means of smoothing out irregularities and asymmetries that remain after initial rhinoplasty surgery. An article appearing in the November/December issue of Aesthetic Surgery Journal, a publication of the American Society for Aesthetic Plastic Surgery (ASAPS), discusses the potential benefits and risks of soft tissue fillers as an adjunct to surgical reshaping of the nose.

Injectable fillers allow surgeons to correct post-surgical imperfections without the expense, anesthetic risk, or recovery downtime involved with additional surgery
According to ASAPS statistics, rhinoplasty is among the top five surgical cosmetic procedures, with 152,434 procedures performed in 2008. With the growing availability, variety and popularity of filler materials, it stands to reason that the potential use of these products in conjunction with nose reshaping would be explored.

“Injectable fillers allow surgeons to correct post-surgical imperfections without the expense, anesthetic risk, or recovery downtime involved with additional surgery,” says Steven Dayan, MD, one of the ASJ article’s three authors and clinical assistant professor in the Department of Otolaryngology, University of Illinois Medical Center in Chicago.

Hyaluronic acid (HA), calcium hydroxylapatite gel (CaHA), and liquid silicone (all used off-label) have been used to treat nasal deformities with varying degrees of success. Silicone is generally not recommended, however, because of the greater risk of severe complications such as nodules, cellulitis and ulceration. “The use of any soft tissue filler in the nose should always be approached with caution and with thorough consideration of a patient’s individual circumstances,” says Dr. Dayan.

As with all injectable filler treatments, technique is paramount to success. Limiting the use of fillers to the top and sides of the nose while generally avoiding the base and tip, and placing the fillers at the proper depth in the skin, are important for minimizing complications such as a bumpy appearance, soft tissue damage, or compromising of the blood vessels in the nose.

While soft tissue fillers may be an effective treatment for certain post-surgical deformities, they are generally not recommended as a first-line option for nasal reshaping. Neither are they recommended for patients considering revision surgery, since persistent material in the nose may complicate a future procedure. “Fillers are no substitute for excellent surgical results,” cautions Dr. Dayan. “Rhinoplasty surgeons must continue to strive for perfection in the operating room.”

“Injecting fillers into the nose requires a high level of skill as well as a thorough understanding of nasal structures and soft tissues,” says ASAPS President Renato Saltz, MD. “To minimize the risk of poor results or serious complications, patients should seek treatment only by a board-certified physician with relevant training and experience.”

This rhinoplasty news article came from this link.
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I hope this injectables will not pose any health threats to rhinoplasty patients. What do you think?

Senate Democrats Would no longer tax Rhinoplasty

2009-12-20T04:33:00.000-08:00

Your fears of a 5 percent tariff on butt lifts, rhinoplasty, and injectables like Botox and Restylane are over! Senate Democrats have dropped the so-called "Botax," likely after major uproar from the well-moneyed cosmetic surgery industry, which was supposed to raise $5 billion. But don't think Dems have entirely thrown out the idea of taxing America's addiction to aesthetic improvements: The cast of Jersey Shore is about to see their tanning experience get hit with a hike.

In place of Botax is a 10 percent tax on indoor tanning. Or, as the Senate's bill refers to it, the tax will be "intended for the irradiation of an individual by ultraviolet radiation, with wavelengths in air between 200 and 400 nanometers, to induce skin tanning." Which, as far as we're concerned, is a tax on WHITE PEOPLE!

Looks like spray-ons it will be.

SOURCE

Rhinoplasty Stories : Camilla Belle

2009-12-06T05:18:00.000-08:00

Young actress Camilla Belle may be most recognizable for her heavy dark eyebrows, but Make Me Heal is more interested in the possible nose job the brunette beauty may have had to achieve star status.

At 23-years old, Camilla has achieved a lot, becoming an in demand actress and dating a Jonas brother. But has she also had a rhinoplasty to help her rise to fame?

In addition to thinning her eyebrows as she ages, it also looks as though Camilla’s nose may have thinned out a bit too. However, it could be a result of clever makeup application, rather than plastic surgery.

Manhattan plastic surgeon Dr David Shafer says, “Camilla Belle dose not need anything in particular. Her nose does look a bit narrower in the pictures, but it is unclear whether she has had surgery. “

On the other hand, Camilla’s newly thinned nose could be the result of a clever plastic surgeon doing a well-done nose job.

Plastic surgeon Dr Sherrell J Aston says, “From the photographs I can see, it appears that Ms. Belle has had a Rhinoplasty. Her facial changes are mostly visible when looking at frontal photographs. One can see that the width of her bridge is much more narrow now. Her surgeon also refined her tip and nostrils. I think that her plastic surgeon did an excellent job with achieving a natural look.”

Whether or not Camilla has been under the knife, she looks great and is sure to continue to rise to the top of Hollywood’s elite.

SOURCE

Rib Cartilage Grafts in Rhinoplasty

2009-11-23T05:47:00.000-08:00

Rib cartilage from human donors is well tolerated as a grafting material in nasal plastic surgery and yields positive functional, structural and cosmetic results, even in complex cases, according to a report in the November/December issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.

"The search for the ideal nasal implant remains an ongoing effort," the authors write as background information in the article. "We desire a substance that is readily available in large quantities; resists infection and absorption; is completely integrated into host tissues; causes little patient morbidity [illness or injury]; and can be molded, shaped or carved with ease." The patient's own cartilage is often the preferred choice, but is sometimes too thin, there is an insufficient quantity or it may cause problems at the site from which it is removed. Irradiated homologous costal cartilage -- donor tissue from human ribs that has been treated with radiation to decrease the chances of an immune response or resorption once placed in a donor -- could serve as an alternative.

Russell W. H. Kridel, M.D., of the University of Texas Medical School at Houston and Facial Plastic Surgery Associates, Houston, and colleagues reviewed the medical charts of 357 patients who underwent primary or revision rhinoplasty (nasal plastic surgery) using autologous costal cartilage as the principal graft material between 1984 and 2008. The patients were an average of 37 years old and were followed up for an average of 13.5 years (and for a range of four days to 24 years). The 1,025 homologous costal cartilage grafts and 373 other grafts used were evaluated for warping, infection, resorption (being absorbed back into surrounding tissues) with or without infection, mobility and extrusion (forcing out). Forty-two patients also completed a satisfaction evaluation.

The total complication rate related to irradiated homologous costal cartilage grafts was 3.25 percent, including 10 warped grafts, nine infections, five cases of infective resorption, five non-infective resorptions and three cases of graft mobility. Among the nine cases of infection, two patients received grafts using homologous costal cartilage alone and seven in combination with other materials, so the infection rate related to the use of homologous costal cartilage alone was two of 1,025 (0.2 percent).

"Not only did very few complications occur following the use of 1,025 irradiated homologous costal cartilage grafts in 357 patients after 386 rhinoplasties over 24 years (rate, 3.25 percent), but the rate of complications was no greater than rhinoplasty complication rates when autologous [the patient's own] cartilage grafts are used," the authors write.

During an average follow-up of 7.9 years, 94.2 percent of patients reported being satisfied with the results, considering categories such as their appearance, ability to breathe and quality of life. The irradiated homologous costal cartilage was not associated with any allergic reactions or systemic diseases and also proved to be reliable in patients with autoimmune diseases and in those with complex cases involving repairs of perforated septal tissue.

"The results indicate safety and reliability and justify the convenient use of irradiated homologous costal cartilage grafts for primary and revision rhinoplasty without creating donor site morbidity," or damage to the area from which an individual's own cartilage is harvested, the authors write. "Irradiated homograft cartilage grafts should be considered as an alternative or even a primary grafting material when the patient does not have adequate quantities of septal or auricular [ear] cartilage remaining to provide the correction or when the shape or quality of such an autologous cartilage does not adequately provide the structure required."

Editorial: Papers Highlight Science of Facial Plastic Surgery

"As we begin our second decade of publication, the Archives of Facial Plastic Surgery has evolved but maintained its original vision," writes Wayne F. Larrabee Jr., editor of the journal, in an accompanying editorial. "Two significant articles in this issue epitomize our mission to 'promote the art and science of facial plastic surgery by publishing significant peer-reviewed articles in all aspects of reconstructive and cosmetic surgery of the head and neck."

"The first article -- 'The Technical and Anatomical Aspects of the World's First Near-Total Human Face and Maxilla Transplant' by Alam and colleagues -- presents the first successful combined face and maxilla transplant, which was performed on a patient who had undergone 23 previous reconstructive procedures," Dr. Larrabee writes. "The second article -- 'Long-Term Use and Follow-Up of Irradiated Homologous Costal Cartilage Grafts in the Nose' -- epitomizes the meticulous clinical observation that we all should strive to achieve in our practices."

"As we strive to fulfill our mission statement to publish 'the most accurate information available,' the quality of the clinical science in our manuscripts becomes progressively more important," Dr. Larrabee concludes. "Facial plastic surgery is an art and craft, but results must be reported based on sound clinical science."

SOURCE

Rhinoplasty common in Turkey

2009-11-20T05:26:00.000-08:00

In Turkey, rhinoplasty is the most common operation in the field of facial plastic surgery and has gained increasing popularity especially within the past decade. There are many reasons for this increase. First, traditional Turkish noses are usually big, with humps of varying degrees. Second, image has become very important, especially among younger adults (those aged 18 to 25 years). Third, the number of surgeons performing this operation in Turkey has increased exponentially within the past decade. Fourth, the costs of the operation have also decreased, so rhinoplasty is no longer an operation only for rich people in Turkey.

Turkey has about 72 million inhabitants, and it is estimated that there are an additional 5 million Turks living outside the country. Throughout history, this region has been a cradle of many civilizations and a melting pot for people from many countries. Therefore, although it is almost impossible

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Rhinoplasty Risks

2009-11-09T07:53:00.000-08:00

Although rhinoplasty is a very common surgery, there are nevertheless risks that should be taken into account by anyone considering the procedure. The dangers of rhinoplasty - such as permanent nerve damage after rhinoplasty - are few, but like every invasive procedure, rhinoplasty will always have its potential problems. Fortunately, most nose surgery procedures are problem-free, but patients should educate themselves on potential nose job risks and speak with a surgeon before moving forward with the procedure.

Risks Associated with Rhinoplasty Surgery

There are risks associated with any surgery, such as bleeding, infection, adverse reaction to anesthesia, and hematoma (when blood collects under the skin; a hematoma has to be removed surgically).

The specific dangers of rhinoplasty/nose surgery include numbness, nosebleeds, scarring at the base of the nose (this may occur when the nose surgery is an "open rhinoplasty"), bursting of small blood vessels on the surface of the skin, swelling, permanent nerve damage after rhinoplasty, or under- or over-correction that necessitates secondary/revision rhinoplasty.

Before your nose surgery, you will consult with your doctor about the possible risks; the doctor will also address any questions and concerns you may have. Following your surgeon's instructions for your pre- and post- nose surgery care will help to avoid almost any problem and greatly diminish the risk factors.
Nose Surgery Recovery and Problems with Depression

Immediately after their nose surgery, patients may feel discouraged with the results of their procedure. Because there can be considerable swelling, the initial effects of rhinoplasty may not be apparent for weeks and the final result may not be attained for many months. However, as the nose heals and the swelling subsides, most patients feel that their rhinoplasty goals have been achieved. Patience, a thorough understanding of the procedure, and allowing ample rhinoplasty recovery time are important for both surgical success and patient satisfaction. After the full recovery time, a patient will be better able to see the results of their much anticipated nose surgery, and will most likely be problem-free and very pleased with their new look.

SOURCE

More on Rhinoplasty and Cosmetic Plastic Surgery Do-Over

2009-11-03T20:57:00.000-08:00

NO face-lift stops time, so as aging continues, even a satisfied patient may choose to have another one a decade later. But what if your face-lift never pleased you, not because of complications or monstrous scars, but because of aesthetics pure and simple? Perhaps your first surgeon’s technique resulted not only in a tighter jaw line, but also a flat wind-swept cheek and a stretched mouth. Or your nose no longer has an unsightly bump, but now, postsurgery, is asymmetrical.

These days, there’s such a critical mass of plastic surgery patients dissatisfied with their results that many doctors market secondary surgeries, or re-dos. It’s not hard to find surgeons’ Web sites that describe in detail how an asymmetrical nose job or an unsatisfactory face-lift can be righted. Last month, Dr. Sam T. Hamra, a plastic surgeon in Dallas, published “The Facelift Letdown: When Results Don’t Meet Expectations” to arm patients with information so they can better articulate their desires to their doctors and avoid postsurgery discontent.

No organization tracks how many procedures are done to correct cosmetic work. (Muddying the situation is the fact that some doctors tweak their own work if it falls short of the patient’s goals and that some complications call for immediate reoperation, like a hematoma, or a collection of pooled blood, beneath a closed incision.)

In this still-shaky economy, cosmetic surgery is down, and revisions for unhappy patients are included in that slump. But doctors who do a lot of revision face-lifts and nose jobs (two common redos) say demand for those operations is still strong.

Reasons vary, depending on the procedure. Rhinoplasty, for instance, is tricky because surgeons can’t control healing or how good the building materials are. Cartilage can be too thick or too flimsy; skin draped over a newly fashioned nose structure might not shrink to the shape the surgeon wants.

“It’s a difficult operation with a lot of variables,” said Dr. James C. Grotting, the editor of the textbook “Reoperative Aesthetic and Reconstructive Plastic Surgery.” “So even in the best of hands, people who only do rhinoplasty,” he said, there is still “a revision rate of up to 20 percent.” Some of the best fix-it nose doctors are sober about the limitations. Dr. Mark B. Constantian, a nose specialist in Nashua, N.H., whose practice is 75 percent revisions, said rhinoplasty is unique in that “you can lose ground every time.” With other kinds of plastic surgery, patients “are not worse off than when they started.”

Some doctors refuse to tackle secondary or tertiary rhinoplasties, and sometimes patients seeking these operations get unfairly labeled as “a fussy neurotic group,” Dr. Constantian said.

He pinpointed four reasons for dissatisfaction: breathing is worse, which can happen if a doctor doesn’t compensate for aesthetic changes; postoperative deformity that patients don’t like (perhaps removing a bump leaves the patient’s nose crooked); the patient never reached the original goal; and last, the patient got the requested change but now finds it unacceptable. “After, they feel they lost a familial or ethnic characteristic, and ask, ‘Can you do something to put my nose back to what it was?’ ” he said.

One of Dr. Constantian’s revision patients, a nurse in New Hampshire, got her first rhinoplasty in 2004 to fix her nose’s too-wide tip and a hanging columella, the tissue on the underside between the nostrils. As the post-operation swelling subsided, “Everyday I would look and wait for changes,” said the nurse, who asked to remain anonymous. But the nose tip “was still wide” and the columella didn’t look “touched at all.” She searched on Google for nose specialists and found Dr. Constantian. Today her profile is straight, her columella no longer hangs, and she breathes better. “My breathing was never a problem until after the first surgery,” the nurse said.

Sometimes earnest miscommunication between patient and doctor is at the heart of the matter. “What the patient is seeing in their mind is hard to describe to the doctor,” said Dr. Jack P. Gunter, who devotes 40 percent of his nasal-surgery practice in Dallas to redos. “Patients will say, ‘I just want a little taken off.’ How much is a little?” Other doctors sweet-talk patients into thinking the perfect nose or face-lift is within reach, leading to discontent. “People are marketing things they cannot achieve,” Dr. Gunter said.

These days advertising creates unrealistic expectations, said Dr. Grotting, whose practice is in Birmingham, Ala. The idea that a procedure can be quick, simple, painless, “all of these catchphrases are heavily marketed to plastic surgery patients,” he said.

When it comes to plastic surgery, Dr. Hamra said, the “customer is always right.” A gynecology patient isn’t the one to determine if she wishes to spend less money to remove fewer of her uterine fibroids. A plastic surgery patient, however, can choose a minimally invasive face-lift instead of a more complete one, said Dr. Hamra, who favors comprehensive face-lifts that address upper cheeks and foreheads. If one surgeon won’t give him what he wants, the patient finds one who will.

Celebrity cases of too many face-lifts overshadow a common problem these days: paying thousands for small improvements that don’t last.

“In face-lifts, you see undercorrections,” said Dr. James M. Stuzin, a plastic surgeon who specializes in face-lifts in Miami and does a “big volume of redos.” Mini face-lifts, he said, require “little recovery,” but have “little longevity.” He also cautions that some surgeons who do only occasional face-lifting “don’t reconstruct the internal anatomy, and that has more longevity.”

In other words, you get what you pay for. “I’m seeing more people who have gone to clinics where price is a major concern for them going there, and often they are dissatisfied with the result,” said Dr. Stuzin, a past president of the American Society for Aesthetic Plastic Surgery. “Instead of muscle work, they are oversuctioning the neck, so the neck looks skeletal.”

Furthermore, not every plastic surgeon tailors his work to each face, but instead “do it the same way every day, and that doesn’t work for faces,” said Dr. Mark E. Richards, a plastic surgeon in the Washington, D.C., area. Patients have sought out Dr. Richards for revision face-lifts ever since Linda Tripp announced on TV that he redid her botched face-lift in 2000.

Other experts caution to be wary of the doctor whose technique is stuck in the dark ages. “There are still a lot of surgeons who just redrape the skin — that’s it,” Dr. Grotting said.

For decades, doing face-lifts hasn’t been about simply pulling the skin toward the ear. At the very least, underlying layers of tissue and fat should be repositioned; some doctors also try to restore the curves and volume lost to aging.

Lately, Dr. Richards says that he has found that many of his unhappy patients are missing “cheek curves.” Pulling the connective and fatty tissue layers just below the skin “doesn’t make an attractive face,” he said. “It just makes a tight face.”

Surgeons’ philosophies vary widely, so it’s crucial to meet with a few to ascertain which one will best achieve your goals. Some love a high full cheek or use transplanted fat to fill out that area. Others think a face-lift that doesn’t address the eye area is incomplete. And some aim to deliver simply a tight neck and a defined jaw line. Dr. Hamra’s guide advocates the composite face-lift, a fairly aggressive surgery that also addresses hollow eyes and lifts cheeks vertically. (If readers can get past the book’s dollops of self-promotion, its descriptions of post face-lift issues prove useful.)

Dr. Constantian, for his part, wrote a new textbook “Rhinoplasty: Craft and Magic” because he feels the “basic ideas of how to fix a nose aren’t correct.” Two misconceptions get surgeons started on the wrong foot, he said. First, the mistaken notion that if a surgeon fashions a good-looking skeletal shape, skin draped over it will “take on the nose shape.”

Not so. The skin of the lower nose “won’t necessarily shrink to the shape the surgeon wants,” Dr. Constantian said.

“We were taught if you just change one area in the nose, nothing else changes,” he added. But “if you reduce the tip cartilage to make it prettier, you can also weaken the ability of the cartilage to support the nostrils,” he said. So he compensates for that weakness.

But some surgeons think impaired breathing is an acceptable trade-off for aesthetic improvement. “Breathing worse after a rhinoplasty is so common that I’ve heard surgeons say on panels at meetings that they expect it to happen, they tell their patients it will happen,” Dr. Constantian said. “I don’t think it should ever happen.”

Dr. Joseph M. Gryskiewicz, the vice president of the Rhinoplasty Society, a nonprofit educational organization for surgeons, wrote in an e-mail message, “Only a sadist would say breathing compromise is O.K.”

This article is from www.nytimes.com By CATHERINE SAINT LOUIS
Published: October 28, 2009

Special Offer from Rhinoplasty Specialist

2009-10-28T08:08:00.000-07:00

Dr. Jennifer Levine, famous Rhinoplasty specialist has revealed a great offer on facial surgery procedures for everyone. Available on October 29, 2009, this offer is valid between 4 P.M. and 7 P.M. a discount of 15% will be given on cosmetic procedures like Botox, Juvederm, Perlane, Restylane, Radiesse, Clinique Medical, Chemical Peels and Revale Skin. If you bring along a friend, these facial and skin care treatments can be taken at 20% off the original price. Free supply of Latisse (retail price: $160) can also be availed by the first 10 people to take treatment.

As the web portal of an eminent New York cosmetic surgeon, Dr Jennifer Levine provides all the essential facts and guidance needed to make informed medical choices. Not only is Dr Levine a certified Facial Plastic Surgeon but also one of the few female Plastic Surgeon New York

The home page of this informative site is quite appealing and offers easy access to information about various treatments like Blepharoplasty Surgery, Rhinoplasty Surgery NY and even facelift surgery ny. Specializing in face and neck lift, Dr Jennifer Levine also conducts eyebrow lift surgery, Chin Implants NY and cheek implants.

Every procedure is conducted with great care and minimal invasion. Unlike many otherBlepharoplasty NY and Rhinoplasty NY surgeons, Dr Jennifer Levine Best rhinoplasty surgeondiscourages the surgical look through stylized treatments. Subtle changes are made in the individual’s facial features to enhance their beauty and proportion. The focus is on natural changes rather than excessive surgical procedures.

Patients can read more about each kind of procedure in the different sections of Dr Levine’s website, drjenniferlevine.com. The main categories include face and neck lift surgery, nasal surgery, eyelid lift, brow and forehead lift, chin and cheek implants. A separate section informs people about the treatment for reducing wrinkles and blemishes to get a youthful, supple and fresh appearance.

Apart from New York patients, drjenniferlevine.com also provides services to out of town patients. Fixing appointments for specific, personalized treatment is very simple through this site. They offer latest and innovative technology for all procedures of facial plastic surgery,Rhinoplasty manhattan, face and neck lift, and Blepharoplasty NY. Previous successful cases can also be viewed on drjenniferlevine.com to compare the facial problems of before with the rejunivated and corrected features after surgery.

Visit them at http://www.drjenniferlevine.com

240 East 79th Street

New York, NY 10021

Telephone: 212.517.9400

Facsimile : 212.585.2604

India Offers Rhinoplasty

2009-10-20T08:28:00.000-07:00

Medical tourism in India offer Rhinoplasty in Goa combined with a first class holiday for what you would expect to pay only for the surgery back at home.

With high success rate of cosmetic surgery and better sunshine and weather has made people across the globe to come to India for getting medical care, not to forget the cost benefits and quality at par with international standards. Rhinoplasty in Goa India is done based upon dependable international standards that are comprehensively applied by surgeons and doctors, all of whom been formally trained in the UK or USA. Medical tourism in India aims to be the world leader in organized international cosmetic surgery holidays at Goa and have invested considerable time and money in ensuring that you receive nothing other than the best, most affordable quality surgical care possible, in the most relaxing environments, where you are fully looked after by our professional staff.

Rhinoplasty, otherwise known as nose job is a surgical procedure used to sculpt the nose to improve its original shape and size. It is an elective surgery used to modify nasal tip, to reduce the dorsal hump, to narrow nostrils, to reduce the width of the nose and to make other such nasal corrections. Each face has its own proportions, volumes, angles and outlines and Rhinoplasty can only tweak the features of one's face to make one's appearance better. The procedure is generally done on an outpatient basis and takes around two hours for the procedure to be completed. Since incisions are made inside the nose, only light scars are left after surgery which will fade in about two weeks time. The patient will not experience severe pain after surgery and even that will be compensated through medications

Rhinoplasty calls for the skill of the plastic surgeon. India has got both technology and skilled doctors who have successfully performed Rhinoplasty in India at a cost which is less than half when compared with western countries. Rhinoplasty in Goa India is provided at some of the leading organizations in the world providing high quality cosmetic surgery by qualified and experienced American and British board certified surgeons working in state of the art facilities. The surgery is combined with a luxurious stay in a beautiful resort environment of Goa- the perfect place to fully relax, recover and recuperate body and mind before returning home. Beautiful Goa India has a reputation that precedes itself as far as medical tourism is cornered. With skillful surgeons, rock-bottom prices, and up-to-date technology, India is an easy favorite for many medical tourism travelers; especially those looking for beautifying procedures.

To get more info on Rhinoplasty in Goa India visit us at www.tour2india4health.com. Or mail at enquiry@tour2india4health.com or you can call us at +91-9371136499, +91-9860755000

Current Trends in Rhinoplasty : An Expert Interview with Sherrell J. Aston MD

2009-10-16T10:40:00.000-07:00

Rhinoplasties are increasingly popular procedures. A complex procedure, the rhinoplasty has in recent years seen changes of opinion in how this surgery should be performed, such as more attention to protecting or enhancing architectural integrity. Medscape's Pippa Wysong spoke to Sherrell J. Aston, MD, who offered his thoughts on the state of the art in rhinoplasty. Dr. Aston is Director and Chairman of the Department of Plastic Surgery at Manhattan Eye, Ear and Throat Hospital in New York, NY. He is also Professor of Plastic Surgery at the New York University School of Medicine, New York, NY, and is certified by the American Board of Surgery (ABS) and the American Board of Plastic Surgery (ABPS).

Medscape: Rhinoplasties are becoming more popular. Why is this, and who is having all of these rhinoplasties?

Dr. Aston: Most rhinoplasties are performed to change the cosmetic appearance of the nose. Most are performed in teenagers and young adults, but increasing numbers have been performed on people ranging from their 30s to their 60s. Breathing problems are frequently corrected during rhinoplasty.

Medscape: Are women still the main patient population for rhinoplasties?

Dr. Aston: Yes; however, about 15% of the noses in my practice belong to men. The incidence of men having rhinoplasties is a little higher than the incidence of men having facelifts. A large percentage of men who want rhinoplasties are in their late teens and early 20s. In men we perform rhinoplasties at a slightly older age than we do in women because a boy's face matures a little later.

Medscape:People might ask their surgeons whether it's possible to have a limited procedure, eg, take away the bump or change the tip. Is that realistic?

Dr. Aston: Only a small percentage of noses will look good with a limited procedure. The appearance of the nose depends on the relationship between all of the parts. If you change the tip, eg, make it smaller, it reduces some of the tip support and has the potential to make the profile look taller. On the other hand, if you just take a bump off the nose without touching the tip, it's possible that the tip will look bigger than it did before. When you alter one area, it influences the appearance of other areas of the nose.

Medscape: Are there any exceptions?

Dr. Aston: Yes; some patients have small bumps on their profiles (a thin tip with good projection), and you can just sand down the bump. Some noses have wide tips with good tip projection, and the patient's profile won't be reduced. A small number of patients don't need profile reductions or tip reductions, and you can do limited procedures. Today's rhinoplasty is more conservative than it was years ago.

Medscape:In what ways is rhinoplasty more conservative these days?

Dr. Aston: Today it's important to maintain architectural integrity because noses change over time. Twenty years after surgery, noses don't look the way they did 5 years after surgery. The skin sleeve of the nose eventually gets thinner. When I say skin, I'm including the fat layer and muscle overlying the cartilage and bones. Many rhinoplasties that were done 30-40 years ago and looked good a year after surgery, don't look as good today because less attention was paid to preserving architectural integrity.

Medscape:Preserving architectural integrity -- is that a state-of-the-art message?

Dr. Aston: Absolutely. State of the art is maintaining architectural integrity in both the bony and cartilaginous framework of the nose. In the patient lacking natural architectural integrity of the nose, we add it by borrowing cartilage from the septum, a rib, or possibly from the ear.

Medscape: What are some ways to preserve architecture? Does this commonly need to be done?

Dr. Aston: Yes, even in routine rhinoplasties. A spreader graft is often performed to maintain the dorsal lines of the nose. It maintains support for breathing in the midvault, gives an aesthetically pleasing contour line, and prevents a pinched look in the middle portion of the nose. We'll add strut grafts to the columella to maintain support of the tip and to give and maintain tip projection. Plus, we use various small cartilage grafts within the tip of the nose to give contour. The goal is to have the nose look normal, and function well.

Medscape:Is it possible to operate on the nose without leaving scars?

Dr. Aston: First, there are 2 basic types of rhinoplasties. One is closed or endonasal rhinoplasty. Incisions are made inside the nose to release the nose from its architectural framework, so one can work on the tip cartilage (the cartilage in the midvault of the nose), the nasal bones, and the septum. In my practice, a vast majority of rhinoplasties are performed with the closed technique. The second technique is open rhinoplasty, which requires an incision on the columella. The open rhinoplasty is indicated when the anatomy of the nose is more complex. It is also used in secondary rhinoplasties in which the procedure requires more direct exposure to the tip cartilage than you can get with a closed approach. You can obtain exposure to the nasal anatomy with either technique.

Medscape:Isn't open rhinoplasty more common than closed?

Dr. Aston: Probably, although closed is starting to regain ground. Although open rhinoplasty gives more direct exposure to the nasal anatomy, it leaves a visible scar. In most cases the scar heals well, but this is not always the case. In the past 20 years, the emphasis in plastic surgery residencies has been on open rhinoplasty, partly because you can see the anatomy more easily than with closed rhinoplasty. With closed rhinoplasty you need good 3-dimensional thinking to understand the anatomy and how the changes that you make will look afterward. Some noses have unusual anatomic situations that make open rhinoplasty the preferred technique. Personally, I think a lot of open rhinoplasties would be better if performed closed. Closed rhinoplasties take less time to heal. Open is more invasive and has more swelling.

Medscape: How do you make the tip of the nose look smaller?

Dr. Aston: Traditionally, making the tip smaller involved removing a portion of the tip cartilage. Today, a large number of tips are made smaller by removing very little of the tip cartilage -- sometimes none. Instead, you resculpt, reshape, and reposition the tip cartilage. For instance, if you have a broad bulbous tip, and the alar cartilages don't meet at the midline, you can remove small parts of the cartilages, but also change the angle of the tip cartilage so that the domes are made more acute. You can suture the domes of the 2 cartilages together to reposition them and make the tip smaller, which also makes the tip more triangular in shape and provides a more desired contour. Simply resecting cartilage in many tips won't do that. Many noses require cartilage grafts placed in the tip to support and project the tip. In some noses you actually make the nose look smaller by placing the grafts in such a way that it increases the tip projection, and supports the sidewalls. There are numerous options.

Medscape: What happens to the skin of the nose when you make the cartilaginous and bony framework smaller?

Dr. Aston: The skin of the nose contracts to conform to the bone and cartilage underneath. Removing skin has no place in routine cosmetic rhinoplasty. The scars would be unacceptable. You should leave the skin and let it shrink down. Skin type and thickness play a huge role in the final result.

Medscape: What's done to make breathing better with a rhinoplasty?

Dr. Aston: It depends on the etiology of the breathing problem. Repair of a deviated septum is common. If patients present with compromised valves, spreader grafts are used to maintain the internal valves of the nose. Sometimes internal valves could become compromised as part of the reduction rhinoplasty, but spreader grafts keep them open. Not infrequently, we alter the inferior turbinates to help open up the airway. Some noses need cartilage grafts to support the nasal tip and prevent the nostrils from collapsing.

Medscape: What does it mean to break the nose during rhinoplasty? Is it necessary?

Dr. Aston: It's necessary in probably 90% of rhinoplasties. When you lower the profile, you usually need to reduce the width of the base of the nose. A lateral osteotomy divides the ascending process of the maxilla on the sides of the nose so that you can adjust the base of the nose. If you lower the profile and don't narrow the sidewalls, then it will look too wide. Osteotomies can lead to bruising, but are much less traumatic than they were years ago.

Medscape: Do you have any general tips for physicians with regard to follow-up of rhinoplasty patients?

Dr. Aston: All noses take a minimum of 1 year for the swelling to go down. That doesn't mean that the nose doesn't look good 2 weeks after surgery, but refinements in the appearance occur over time. In patients with thicker skin it can take longer. It's important to convey this to patients.

Medscape: You've given everyone a lot to think about. Thanks for taking time to speak to Medscape.

SOURCE : medscape.com

The Miss Plastic contest finals take place in Hungary

2009-10-12T19:32:00.000-07:00

The Miss Plastic contest is a beauty contest with a difference: only those who have had plastic surgery can take part. Indeed, several of thh participants have been thrown out of other contests after it was found that they were less natural than their competitors.

Fun though the whole idea of the Miss Plastic contest is it's not really about the women or their looks at all. It's a showcase for the skills of the plastic surgeons. For example, it's isn't how breasts look in a swimsuit or an evening gown that excites the judges. It's whether there are any visible scars to betray the augmentation. As might be imagined, competition to be a judge is fierce given the detailed examinations of the contestants which are necessary.

As well as fun the Miss Plastic contest is also amusing: the at one time front runner is currently confined to a wheelchair as a result of her surgery. No, nothing went wrong with the actual surgery:

Alexandra had just got through the breast examination stage - where the judges had congratulated her surgeon, Dr Tamas Rozsos, on the lack of any surgical scars.

She toppled over on the catwalk and tore a ligament in her foot. Onlooker Laszlo Feher said: 'Everyone was admiring her bodywork and then she started to topple - no-one was near enough to reach her and she fall badly. She was taken to hospital by ambulance.'

A friend said: 'She had not got used to the extra weight on top and her new hair extensions got in her eyes - she just lost her balance and tore a ligament in her foot badly.'

Not, perhaps, the very finest advertisement for plastic surgery.

SOURCE: www.examiner.com

Are You a Good Candidate for Rhinoplasty Surgery?

2009-10-09T08:17:00.000-07:00

The development of rhinoplasty occurred primarily as a plastic surgery technique to restore a proportional nose shape, or to correct for constricted breathing, whether after injury or due to a birth defect. In addition to these corrective procedures, surgeons now use cosmetic plastic surgery to perform subtle aesthetic changes to nose size and shape.

The Rhinoplasty Procedure

Rhinoplasty, or nose reshaping, is one of the most common cosmetic plastic surgery procedures. It is the second most popular surgical cosmetic procedure in the United States (according to the American Society of Plastic Surgeons). Rhinoplasty reshapes the nose for both aesthetic and corrective purposes. Rhinoplasty can enlarge or reduce the nose, as well as reshape the bridge and nose tip.

Best Rhinoplasty Candidates

You may be a good candidate for rhinoplasty if the nose you were born with makes you self conscious or unhappy. Other candidates may be unhappy with how their nose has aged. Even slight changes to the shape of the nose can have a dramatic effect on appearance and can change how people interact with you. Plastic surgery can reshape deformities, reshape changes from aging and other causes, and restore balance.

Expectations are an important element in what makes a good candidate. The best nose surgery candidates simply want to improve the nose appearance, but do not seek perfection. The ideal candidate should not expect rhinoplasty to transform them into someone else. The best candidates are well adjusted and otherwise happy with their lives.

Minimum Age for Rhinoplasty

Many young people consider rhinoplasty; however, the procedure should wait until after the teenage growth period that occurs in the mid-teens. This growth period normally occurs from ages 14 to 15 for girls and somewhat later for boys.
Additional Procedures

Sometimes treating one area can cause an overall imbalanced appearance. If you are having the rhinoplasty procedure, you may also need to consider other facial procedures to achieve balance and proportion. For example, chin augmentation is often performed with rhinoplasty.

If you decide you need the additional procedure later, the two procedures may be more expensive than if you have them at the same time. Multiple procedures are increasingly popular as patients work with their surgeons to create more comprehensive treatment plans. A qualified surgeon can help you save time and potentially lower your rhinoplasty cost by combining treatments when appropriate.

Source : Your Plastic Surgery Guide

Revision Rhinoplasty

2009-09-18T08:25:00.000-07:00

Revision rhinoplasty is a surgical procedure designed to repair both form and function of a nose that has previously been operated on. Many people have difficult breathing from their nose or are dissatisfied with the cosmetic appearance of their nose as a result of prior nasal surgery. In fact, many patients have had several unsuccessful nasal surgeries, even as many as six or seven prior procedures. Because rhinoplasty is one of the most difficult of all plastic surgery procedures, there is a large need for secondary surgeries. Further, this procedure tends to be an even more complicated procedure than primary rhinoplasty, making it essential that patients find a sufficiently qualified and experienced surgeon. Good candidates include physically healthy men and women who are realistic in their expectations and are unhappy with the results of a prior rhinoplasty procedure.

It often takes place in a surgeon’s office-based facility and may be performed with either general anesthesia or a combination of local anesthesia and sedation. The procedure tends to take longer than primary rhinoplasty, which can take one to two hours to perform. Incisions may be confined to the inside of the nose (closed rhinoplasty) or may involve an additional small incision under the tip of the nose (open rhinoplasty). There are times when open rhinoplasty is preferred because it can offer better exposure and an overall better results. Other times, however, closed rhinoplasty is sufficient.

Once the incisions are made, the skin of the nose is separated from the underlying bone and cartilage. What occurs next will depend upon the particular case. Cartilage may be repositioned or missing structures may be replaced. When the desired result is achieved, the skin is then redraped over the new framework and the incisions are closed. Revision rhinoplasty procedure tend to involve less pain and bruising than primary rhinoplasty. Any discomfort that patients do experience can be controlled with pain medication. The splint and stitches are typically removed within six to seven days. Bruising and swelling will occur and, though much of the bruising will have faded by about the tenth day, it can take up to a year for all of the swelling to fully fade. Most patients are able to return to work in about a week, though more strenuous activities will need to be avoided for two to three weeks and patients should avoid bumping or jarring the nose or getting a sunburn for eight weeks.

As with all types of surgery, there are potential complications associated with revision rhinoplasty and these may include the following: adverse anesthesia reactions, excessive scarring, prolonged swelling, pulling of the nose to one side, small burst blood vessels, and the need for additional surgery.

Source : http://www.rhinoplastyrevisions.com/

Depression After a Nose Job

2009-08-25T01:26:00.000-07:00

Many patients—including me—have periods of depression after surgery, especially cosmetic surgery. We begin to second guess ourselves and wonder if we ever should have had the surgery in the first place. We begin to think we are “ugly” and that the bruising and swelling will never go away.

If you are feeling this way, you are not alone. In fact, you're quite normal!

Typical Reasons For After Surgery Depression

A period of depression or marked sadness after your surgery can be due to the aftereffects of anesthesia. Anesthesia seems to bring out our sensitive sides and our anxiety.

After surgery depression can also be caused by medications, postsurgical traumatic stress syndrome, constipation from the medications (it's true!), and a general sense that your life is in disarray. Add in being instructed to stay in bed and avoid your usual activities and the fact that you must sleep almost upright for 2 weeks, none of which makes things any better. And you may not being able to smell or taste your favorite foods very well! Throw on top that you are all bruised and can't breathe through your nose. Whew! No wonder you're feeling down!

Pain and discomfort can wreak havoc on the emotional balance of many patients. As I mentioned above, pain medications (and antibiotics) can cause constipation and other digestive problems. You may feel bloated and sometimes even have abdominal pain. Some surgeons suggest a mild stool softener like Colace® or natural remedies such as eating a high fiber diet or eating daikon (Japanese radish) after you are finished with your medications. Daikon and a high fiber diet can help with getting everything in working order again and also flush out residual medications and what not from your system.

Drink plenty of water as you recover! Drinking plenty of water helps both with reducing swelling and preventing constipation. I cannot stress this factor enough.

Even if you know that you might be depressed and sad after your surgery, you tend not to think about it. Print out our Postoperative Emotions Reminder List to help you with your recovery.

It Is Normal to Feel Let Down

The number one reason for depression is that the adrenaline rush is now over.

Imagine that you are expecting something that you have anticipated and you are just so emotionally and mentally excited that you are getting a physical adrenaline rush. You start to believe everything is going to be wonderful and that as soon as your cast comes off your problems will be over and a perfect nose will sit on your face. Then, the cast is removed and well, you are bruised swollen, and uncomfortable. What gives?

According to Hamid Massiha, MD, a plastic surgeon in practice in New Orleans, depression after cosmetic surgery is very normal:

"Quite frequently patients experience a brief period of let-down or depression after cosmetic surgery. Some may subconsciously have expected to feel and look better ‘instantly,’ even though they rationally understand that this will not be the case. Patients commonly question their decision to have surgery during the first few days after surgery. As the healing occurs, these thoughts usually disappear quickly. If you feel depressed, understanding that this is a natural phase of the healing process may help you to cope with this emotional state."

This “let down” feeling is normal during rhinoplasty recovery so take this into account. You can even write down what to expect before your surgery so you can read it afterwards when you are feeling blue. This will help you keep things in perspective and prepare your mind. It was also remind your brain that you did know this was going to happen. You're not crazy. You're just going through a low. It should subside.

However, if the period of depression and severe sadness continues, speak with your surgeon about it. The temporary depression that can accompany cosmetic surgery can trigger a deeper depression. You can get a referral to a therapist. If you had any other medical problem, you would do something about it, right? Depression is no different. Talking to a therapist can do more good than you think. Therapy does not need to be long and difficult. Frequently, just a few talks with a mental health professional can help.

SOURCE

Rhinoplasty Recovery

2009-08-18T01:23:00.000-07:00

Take this as a given: Recovery after rhinoplasty surgery is not comfortable. You won’t be in huge amounts of pain, or at least you shouldn’t be, but there will be bruising and swelling as well as a stuffed up feeling for at least the first few days.

If your surgeon has given you prescriptions for pain relievers and antibiotics, get the prescriptions filled in advance so that you have them ready when you get home. Take the antibiotics on time and take them for as many days as you are instructed to.

Don’t try to tough it out by not taking pain relievers. If you need them, take them. You will use less pain medication if you take it when the pain starts rather than waiting for the pain to be unbearable.
You may or may not have nasal packing, which is stuffed up your nose to help reduce swelling and bleeding. Packing will make you feel like your whole head is stuffed up and sometimes it can make you feel as if you were smothering. Some people feel overwhelmed a bit by having the packing in their nose. The swelling in your nose may feel like a lot of pressure in that area and can also be a bit upsetting. Some surgeons place a tube or straw in the middle of the nasal packing to help you breathe a bit easier. Your packing, if you have it, will be removed in a few days at your first postoperative appointment.

Some surgeons do not recommend using cold compresses, so check with your surgeon first. However, swelling and pressure can be relieved by icing and many surgeons strongly recommend this. Some patients report that the best things to ice it down with are bags of frozen peas or frozen raspberries. Just be careful you don't puncture the bag from freezing and thawing. It can be a real mess.

Another good trick is to mix one part rubbing alcohol with three parts water. Put a cup of this mixture into a Ziploc bag and seal it and then put that bag inside another Ziploc bag and seal it and place it in the freezer for a few hours. This freezes into a slushy mixture that can mold to your face. Make two or three of these bags so that one is always ready. You can also purchase cold packs that are specially designed for rhinoplasty recovery.

Remember you will be bruised so don’t get too frightened when you look at yourself in the mirror. Most people get two black eyes after nose surgery, so count yourself lucky if you don’t. These bruises may increase or darken as they heal, just like any other bruise, and may go through some lovely shades of purple, green and yellow before they face completely. It usually takes about 10 days for the bruising to disappear completely. However, in smokers it can take up to 3 to 5 weeks. So, quit smoking now for a better chance at a smoother and faster recovery

SOURCE

Tips and Traps of Rhinoplasty

2009-08-11T01:12:00.000-07:00

As with any surgery, there are things that you want to be aware of before committing to the procedure. This page covers some helpful tips to follow and traps to be aware of when you are interviewing plastic surgeons and deciding whether or not to have the surgery done.

    * Know exactly what you want changed and how you want it changed before you see your plastic surgeon. It’s important that you have an idea of what you want the results of your surgery to be. Make a list of the changes you want and be sure to bring the list with you to your consultation visit.

    * Avoid any surgeon who downplays the difficulty of having a nose job. This is a difficult procedure and comes with its own list of possible complications. Be weary of any surgeon who says differently.

    * The older you are, the more difficult it will be for you to adjust to your new nose. Carefully consider rhinoplasty surgery if you are over 40. People over 40 who have nose jobs tend to think the nose they see in the mirror is attractive, but they don’t think the person they see looks like himself or herself. It can take years before they become accustomed to their new look. The older they are, the longer it takes.

    * Avoid all nasal medications for three months before surgery. Many nasal medications can interfere with healing.

    * Ask your plastic surgeon if he or she can avoid placing nasal packing in your nose following surgery. Packing is often not necessary and causes significant discomfort while it is in place and upon its removal.

    * For the first two weeks following nasal surgery, use a humidifier and nasal saline spray to keep your nasal passages moist and comfortable.

    * Sleep in a recliner or with your head elevated on pillows for the first several days to minimize swelling. Frequent application of ice is also important to help with swelling.

    * Understand that there is a 20% chance you will want or need revision rhinoplasty surgery. This is because plastic surgery of the nose is difficult and your nose can also change in ways that cannot be predicted following surgery. You must accept this risk before having cosmetic nose surgery and discuss the possibility with your surgeon before you even commit to the surgery.

    * If you require revision surgery, wait at least one year from the date of your last nasal operation. If revision surgery is performed sooner, it will be less likely to accomplish your desired result.

    * Understand that revision nose surgery is MORE difficult than the original nose job. If you need revision surgery, see someone who has significant experience in this which could mean seeking a different surgeon, or making sure that your surgeon is experienced in revision surgeries.

SOURCE

Rhinoplasty: Choosing the Right Nose for You

2009-08-04T00:56:00.000-07:00

Patients don't want to have a new nose that looks obviously ethnically inappropriate. It is important that your cosmetic nasal surgeon to listen carefully to your desires. A patient must be comfortable and confident that there will be not radical changes in the nose. No one wants a nose that it looks almost "stuck on" and fake because of the surgeon's proclivity to deliver the same "boilerplate" nose for all comers.

Asian noses typically exhibit the following features:

    * Low flat bridge.
    * Wide nasal bones manifesting as wide bridge and middle third of nose.
    * Round, sometimes flat tip.
    * Thick skin.
    * Wide nostrils with thick outer walls.
    * Softer, weaker cartilage.

Hispanic noses vary with ancestry. Those whose genetic makeup have a predominance of Spanish (from Spain) genes tend to have lighter, thinner skin, stronger cartilage and other characteristics more suggestive of Caucasian noses.

Those Hispanics whose ancestry is skewed toward Central or South American Indians exhibit the following:

    * High bridge with a prominent bump.
    * Thick skin.
    * Wide, oblong nostrils with thick outer walls.
    * A wide plunging flat tip.
    * Short upper lip.
    * Softer, weaker cartilage.

African-American noses, anatomically, often have some features in common with Asian or Hispanic noses. There is a greater variety and combination of these elements. Here are the features that contrast most with Caucasian noses:

    * Low flat bridge.
    * Wide nostrils with thick walls.
    * Disproportional width compared to length.

For Asian, Hispanic and African-American noses, more often there will be a need for the surgeon to raise the bridge and shore up the tip. Narrowing the nostrils, when needed, requires external incisions which must be artfully performed so that the incisions - tucked within the crease between the wing (outer wall and the wall of the nostril) and the cheek and upper lip is rendered nearly invisible.

SOURCE

Rhinoplasty Costs

2009-07-30T00:48:00.000-07:00

The cost of rhinoplasty varies depending on the surgeon's skill, the geographic area where the surgery is performed, and the type of structural and cosmetic changes made to the nose. Cost cannot be predicted accurately until the surgeon performs an examination and develops a surgical plan.

Rhinoplasty costs range from $3,000 to $8,000. The cost comprises three fees: surgical fee, anesthesia fee, and facility fee. The anesthesia fee ranges from $600 to $1,000, the facility fee ranges from $700 to $1,100, and the rest of the cost is the surgeon's fee.

The most costly aspect of rhinoplasty is the surgeon's fee. This cost is the most difficult to estimate, since the fee can vary greatly depending on the surgeon's training, skill, experience, and other factors. You can learn more about fees from our table of average surgeon fees.

Skill and Training Affects Rhinoplasty Cost

It's important to choose a board-certified plastic surgeon from the American Board of Plastic Surgery, who has extensive, specific rhinoplasty experience, as well as expertise in all areas of facial plastic surgery. Board certification requires specific and rigorous surgical education and training. More highly qualified, board-certified surgeons command higher fees, but they can also help ensure that you receive the most appropriate treatment for your condition, employ the most appropriate techniques, increase your odds of success, and reduce the risk of complications.

The type of certification is also important. There are more than 150 self-designated boards, but only a handful that are designated by the American Board of Medical Specialties (ABMS), such as the American Board of Plastic Surgery. Be sure to ask your surgeon about surgical training and board certification when you investigate the cost for rhinoplasty.

Extent of Rhinoplasty Procedure

The extent of the surgery makes a cost difference. For example, a slight surgical modification or reduction to the point of the nose requires less surgical time than narrowing the bridge or a complete change of shape. The type of rhinoplasty procedure, open or closed, also affects surgical time and cost.

Payments for Rhinoplasty

Some of the cost of rhinoplasty can be covered by insurance if the rhinoplasty procedure is related to modifying the nasal passage to aid in breathing, or another medical necessity. You can ask your surgeon about filing for insurance. Rhinoplasty for purely cosmetic reasons is not covered by insurance.

If the cost for rhinoplasty is too much to pay at once, ask your surgeon about monthly payments. For financing options and tips, continue reading about Patient Financing.

SOURCE

Good Rhinoplasty Candidates

2009-07-27T00:33:00.000-07:00

The development of rhinoplasty occurred primarily as a plastic surgery technique to restore a proportional nose shape, or to correct for constricted breathing, whether after injury or due to a birth defect. In addition to these corrective procedures, surgeons now use cosmetic plastic surgery to perform subtle aesthetic changes to nose size and shape.
The Rhinoplasty Procedure

Rhinoplasty, or nose reshaping, is one of the most common cosmetic plastic surgery procedures. It is the second most popular surgical cosmetic procedure in the United States (according to the American Society of Plastic Surgeons). Rhinoplasty reshapes the nose for both aesthetic and corrective purposes. Rhinoplasty can enlarge or reduce the nose, as well as reshape the bridge and nose tip.
Best Rhinoplasty Candidates

You may be a good candidate for rhinoplasty if the nose you were born with makes you self conscious or unhappy. Other candidates may be unhappy with how their nose has aged. Even slight changes to the shape of the nose can have a dramatic effect on appearance and can change how people interact with you. Plastic surgery can reshape deformities, reshape changes from aging and other causes, and restore balance.

Expectations are an important element in what makes a good candidate. The best nose surgery candidates simply want to improve the nose appearance, but do not seek perfection. The ideal candidate should not expect rhinoplasty to transform them into someone else. The best candidates are well adjusted and otherwise happy with their lives.
Please click here to view an animation about rhinoplasty.
Minimum Age for Rhinoplasty

Many young people consider rhinoplasty; however, the procedure should wait until after the teenage growth period that occurs in the mid-teens. This growth period normally occurs from ages 14 to 15 for girls and somewhat later for boys.

Additional Procedures

Sometimes treating one area can cause an overall imbalanced appearance. If you are having the rhinoplasty procedure, you may also need to consider other facial procedures to achieve balance and proportion. For example, chin augmentation is often performed with rhinoplasty.

If you decide you need the additional procedure later, the two procedures may be more expensive than if you have them at the same time. Multiple procedures are increasingly popular as patients work with their surgeons to create more comprehensive treatment plans. A qualified surgeon can help you save time and potentially lower your rhinoplasty cost by combining treatments when appropriate.

SOURCE

Rhinoplasty Risks

2009-07-26T00:28:00.000-07:00

The decision to have nose surgery is extremely personal and you’ll have to decide if the benefits will fulfill your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.
The risks include:

    * Rupture of small surface vessels of the nose
    * Infection
    * Poor wound healing
    * Anesthesia risks
    * Bleeding (hematoma)
    * Nose asymmetry
    * Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
    * Change in skin sensation (numbness)
    * Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
    * Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
    * Pain, which may persist
    * Unfavorable scarring
    * Skin contour irregularities
    * Skin discoloration and swelling
    * Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
    * Possibility of revisional surgery

SOURCE

Discussing Nose Surgery with Your Doctor

2009-07-25T00:23:00.000-07:00

The success and safety of your nose surgery depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Consultation for Nose SurgeryBe prepared to discuss:

    * Why you want the surgery, your expectations and desired outcome
    * Medical conditions, drug allergies and previous medical treatments
    * Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
    * Previous surgeries

Your surgeon may also:

    * Evaluate your general health status and any pre-existing health conditions or risk factors
    * Examine and measure your face
    * Take photographs for your medical record
    * Discuss your options and recommend a course of reshaping your nose
    * Discuss likely outcomes of a nose surgery and any risks or potential complications
    * Discuss the type of anesthesia that will be used

SOURCE

Reconstructive Rhinoplasty

2009-07-24T00:19:00.000-07:00

Reconstructive rhinoplasty refers to restoring the normal shape and function of the nose following damage from: traumatic accident, autoimmune disorder, intra-nasal drug abuse, previous injudicious cosmetic surgery, cancer involvement, or congenital abnormality. Rhinoplasty can restore skin coverage; recreate normal contours, and re-establish nasal airflow.

Rhinoplasty for traumatic deformity: Traumatic accidents are the commonest cause of nasal deformity. Typically the nasal bones are broken and displaced. Occasionally, the nasal cartilages are disrupted or displaced, and in the worst cases the nasal dorsum is collapsed. Rhinoplasty allows shaving of the displaced bony humps, and re-alignment of the nasal bones after they are cut. When cartilage is disrupted, stitching of the cartilage for re-suspension, or use of cartilage grafts to camouflage depressions allows re-establishment of normal nasal contour. When the dorsum is collapsed, grafts of rib cartilage, ear cartilage, or cranial bone can be used to restore continuity to the dorsum. Although synthetic implants are also available for augmenting the nasal dorsum, cartilage or bone graft from the patient’s own body poses fewer risks of infection or rejection.

Rhinoplasty for collapsed nose due to septum perforation: Autoimmune problems such as Wegener’s Granulomatosis, Sarcoidosis, Churg-Strauss Syndrome, and Relapsing Polychondritis can lead to creation of a hole in the nasal septum, and loss of support in the dorsum leading to a saddle nose deformity. Intra nasal use of drugs such as cocaine, or extreme abuse of nasal decongestant sprays can similarly cause septum perforation and nasal dorsum collapse. Dorsum reconstruction is accomplished through the use of rib cartilage or bone grafts.

Rhinoplasty to correct nasal obstruction following injudicious cosmetic surgery: Reconstructive rhinoplasty after injudicious cosmetic surgery allows the restoration of normal breathing. When nasal cartilages are over-aggressively trimmed during rhinoplasty, the nose can appear pinched and nasal potency compromised. Patients complain of nasal blockage that is worsened by attempts at deep inspiration. Internal cartilage grafts to support the nasal tip (batton grafts) or widen the middle vault of the nose (spreader grafts) can be quite effective in restoring normal breathing. These grafting techniques will increase the size of the nasal tip and widen the dorsum. Khosh et al.

Rhinoplasty for skin cancer excision: Excision of skin cancers from the nose can lead to loss of internal support as well as external skin coverage. Skin cancer excision in the nose is commonly accomplished via the Mohs’ technique. Once the cancer is removed, reconstructive rhinoplasty aims to provide skin coverage utilizing techniques such as skin graft, local skin flaps, or pedicle flaps. If cancer resection leads to loss of tissue in the area of the nasal tip, cartilage grafts are utilized to maintain support and prevent long-term distortion, by the force of scar contracture.

Rhinoplasty for Rhinophyma: Rhinophyma is the late stage manifestation of a skin condition known as Rosacea, where the skin is infected with acne roseacea. The skin in the area of the nasal tip becomes red, thickened, and enlarged as exemplified by W C Fields. Although known acne treatments such as antibiotics and Acutane can halt the progression of this disease, thickening of the skin and obscuring of the nasal tip landmarks can only be remedied by surgical correction. Currently, laser excision of thickened abnormal skin represents the best option in rhinoplasty for Rhinophyma. The CO2 laser and the Erbium YAG laser are the most effective types of laser for this disorder.

Rhinoplasty for congenital nasal deformity: Vascular malformations and cleft lip anomalies are relatively common causes of congenital nasal deformities. In vascular malformations, the disease process can cause distortions of the skin and underlying structure of the nose. In cleft palate abnormalities, the size, position, and orientation of the nasal tip cartilages may be distorted. Rhinoplasty for reconstruction of vascular malformations can involve laser treatment of the skin and possible surgical excision. When the underlying cartilage structure is disturbed, cartilage grafts and stitching of the native nasal cartilages can help improve nasal appearance. In cleft lip patients, reconstructive rhinoplasty allows re-orientation of the nasal tip cartilages. Additional refinements with cartilage grafts to the tip are also frequently employed.

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Rhinoplasty: Definition and History

2009-07-23T00:16:00.000-07:00

Rhinoplasty (Greek: Rhinos, "Nose" + Plassein, "to shape") is a surgical procedure which is usually performed by either an otolaryngologist-head and neck surgeon, maxillofacial surgeon, or plastic surgeon in order to improve the function (reconstructive surgery) and/or the appearance (cosmetic surgery) of a human nose. Rhinoplasty is also commonly called a "nose reshaping" or "nose job". Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes to correct trauma, birth defects or breathing problems. It can be combined with other surgical procedures such as chin augmentation to enhance the aesthetic results.

Rhinoplasty was first developed by Sushruta, an important physician (often regarded as the "father of plastic surgery") who lived in ancient India circa 500 BC, which he first described in his text Sushruta Samhita. He and his later students and disciples used rhinoplasty to reconstruct noses that were amputated as a punishment for crimes. The techniques of forehead flap rhinoplasty he developed are practiced almost unchanged to this day. This knowledge of plastic surgery existed in India up to the late 18th century as can be seen from the reports published in Gentleman's Magazine (October, 1794).
Patient, three days post-op. Procedures included dorsal bone reduction and re-setting and refinement of nasal tip cartilage. The typical orbital discoloration is also present due to trauma and disruption of blood vessels around the eyes. Also present is a splint.

The first intranasal rhinoplasty in the West was performed by John Orlando Roe in 1887. It was later used for cosmetic purposes by Jacques Joseph (b. Jakob Lewin Joseph) in 1898 to help a patient who felt that the shape or size of his nose caused embarrassment and social discomfort. Joseph's first rhinoplasty patient was a young man whose large nose caused him such embarrassment that he felt unable to appear in public. He approached Joseph because he had heard of a previous successful otoplasty, or "ear reshaping," which the surgeon had performed.

Rhinoplasty can be performed under a general anesthetic, sedation, or with local anesthetic. Initially, local anesthesia which is a mixture of lidocaine and epinephrine is injected to numb the area, and temporarily reduce vascularity. There are two possible approaches to the nose: closed approach and open approach. In closed rhinoplasty, incisions are made inside the nostrils. In open rhynoplasty, an additional inconspicuous incision is made across the columella, the bit of skin that separates the nostrils. The surgeon first separates the skin and soft tissues of the nose from the underlying structures. Reshapes the cartilage and bone, and then sutures the incisions closed. Some surgeons use a stent or packin inside the nose, followed by tape or stent on the outside.

The patient returns home after the surgery. Most surgeons recommend antibiotics, pain medications, and steroid medication after surgery. Most people choose to remain home for a week, although it is safe to be outdoors. If there are external sutures, they are usually removed 4 to 5 days after surgery. The external cast is removed at one week. If there are internal stents, they are usually removed at four days to two weeks. The periorbital bruising usually lasts two weeks. Due to wound healing, there is moderate shifting and settling of the nose over the first year.

In some cases, the surgeon may shape a small piece of the patient's own cartilage or bone, as a graft, to strengthen or change the shape of the nose. Usually the cartilage is harvested from the septum. If there isn't enough septum cartilage, which can occur in revision rhinoplasty, cartilage can be harvested from the concha of the ear or the ribs. In the rare case where bone is required, it is harvested from the cranium, the hip, or the ribs. Sometimes a synthetic implant may be used to augment the bridge of the nose.
The lower lateral cartilage (greater alar cartilage) exposed through the left nostril for modification during a rhinoplasty.

To improve nasal breathing function, a septoplasty may also be performed. If there is turbinate hypertrophy, an inferior turbinectomy can be done.

Although rhinoplasty is usually considered to be safe and successful, several complications can arise. Post operative bleeding is uncommon and often resolves without needing treatment. Infection is rare and can occasionally progress to an abscess that requires surgical drainage under general anesthetic. Adhesions, which are scars that form to bridge across the nasal cavity from the septum to the turbinates, are also rare but cause nasal obstruction to breathing and usually need to be cut away. A hole can be inadvertently made at the time of surgery in the septum, called a septal perforation. This can cause chronic nose bleeding, crusting, difficult breathing and whistling with breathing.

If too much of the underlying structure of the nose (cartilage and/or bone) is removed, this can cause the overlying nasal skin to have little shape resulting in a "polly beak" deformity. Likewise if the septum is not supported, the bridge of the nose can sink resulting in a "saddle nose" deformity. The tip of the nose can be over-rotated causing the nostrils to be too visible and creating a pig-like look. If the cartilages of the tip of the nose are over-resected, this can cause a pinched look to the tip. If an incision is made across the collumella (open approach rhinoplasty) there can be variable degree of numbness to the nose that may take months to resolve.

The cost of rhinoplasty varies regionally and between surgeons. If it is for functional reasons, like breathing correction, it can be covered by many health plans. For example in 2006 in Ontario, Canada the provincial health insurance carrier paid $480, while the cost for cosmetic rhinoplasty varied between $1,000 and $10,000.

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