So you had a nose job and you don’t like the result.
Now what are you going to do?
You can always do nothing and live with the result. That’s OK. That’s your decision.
You can go back to the original surgeon or to a new one (of course, one who is board certified by the American Board of Plastic Surgery).
This plastic surgeon may feel you’re a good candidate and give you two options: surgery (secondary or revision rhinoplasty) or non-surgery. In essence, the knife or the needle.
Before your meeting with the plastic surgeon, you may think your only option at this point is a revision rhinoplasty with its attendant cost and recovery. However, this plastic surgeon rhinoplasty expert whom you chose to get a secondary opinion with, surprised you with his honesty, suggesting an altogether different approach to your nagging problem. He offered you a solution that involves less recovery, costs a good deal less and fixes your main concern…
…and it doesn’t involve surgery.
Your new plastic surgeon offered to inject filler into your nose to camouflage the irregularities, smooth and even out your bridge and even give you more of a chic tip. From the front view, by strategically injecting the filler to alter the light reflex and control shadows your deviated nose can even be made to appear straight.
He/she offers you a temporary or permanent filler. The temporary ones can serve as a dress rehearsal, so to speak, if you are unsure as to whether this is a good idea or not. Temporary ones such as hyaluronic acid (e.g., Juvederm ®, Restylane ®, Voluma ®) or calcium hydroxyapatite (Radiesse ®)are good choices. Permanent ones such as Bellafill ®, Aquamid ® (not FDA approved) or fat transfer (a living transplant from your own body) are all excellent fillers in my opinion.
You decide to go for it but you must be counseled to have realistic expectations. Fillers definitely cost less and involve less recovery (a few days of swelling and perhaps minor bruising at worst).
However, the filler solution will:
1. Neither help breathing problems
2. Nor will they treat all forms of aesthetic deformities such as this:
Significantly distorted medial crura of the alar cartilages
So the next time you’re considering altering the shape of your nose with a rhinoplasty of some sort, you may ask your plastic surgeon (hopefully, board certified by the American Board of Plastic Surgery) about the filler option. Albeit, it cannot match the power of an actual surgical rhinoplasty, the non-surgical, filler rhinoplasty can be an excellent alternative to actual scalpel- based surgery in many select circumstances.
In these cases, the needle can be more powerful than the knife as one can see below:
This lady had a distorted nose after a previous rhinoplasty. Her cartilages were visible through her extremely thin skin and were twisted. After Bellafill ® Treatment.Note the improvement of her inverted V deformity and how the nose appears straighterNote how her nasal rims have been dramatically lowered with the off-the-shelf filler. Of course, individual results may vary.
The idea of wearing a bra to bed is nothing new. I estimate approximately 6% of women already realize the benefit sleeping in a bra either because they were advised to do so by a buxom relative with ample bosom or are clever enough to understand how the laws of physics will affect their breasts in the long run.
BREASTS WITHOUT BRAS
Breasts are affected by gravity just in the same way that Sir Isaac Newton noted that an apple is. If the apple is not prevented from dropping to the ground, it will do so and often get damaged in the process. During the day, breasts get pulled towards the earth in the same way and if no support is provided to counteract this force, breasts will eventually elongate and narrow complemented often times with downward facing nipples.
After examining thousands of breasts throughout my 20 years of private practice, I have come to realize that those who sleep in a brassiere generally have perky breasts than those who don’t. Specifically, those who wear a bra during the day and not one at night tend to have breasts which are wider, yet flatter and concave on top with their nipples still point upwards.
Oblique cross-section of breast showing inner anatomy including Cooper’s suspensory ligament’s.
Apart from being blessed with good genetics to imbue your breasts with strong Cooper’s ligaments, collagen and skin there is nothing one can do to to protect your breasts from drooping except good old fashion commonsense prevention – and that comes in the form of a bra.
There is no muscle in the breasts therefore neither exercise nor yoga positions will help. There’s even poorly conceived research stating that wearing a bra creates more drooping of the breast because “they limit the growth of supporting breast tissue, leaving the breast to wither away and degrade more quickly”! In other words, they imply that the stress of gravity is good for the breast, training it like a muscle. If that were the case, patients could simply gain and lose excessive weight repeatedly in order to” train the skin” so that stretch marks can be avoided. OK…but I then wonder why pregnancy results in abdominal stretch marks…hmmmm?
My job as a plastic surgeon is to not just simply do the surgery and wish my patients all the best as they fade into the sunset. I feel it is my responsibility to also provide an “instruction manual” so to speak on how to manage their aesthetic wellness outside of my clinic and operating room.
For example, after facial surgery I recommend specialized skin care regimens and after body sculpting, certain diet and exercise. However, after breast surgery, few if any plastic surgeons recommend long term breast care except for incision/scar management, implant massage and mammograms. You only have one set of breasts and whether or not you choose to undergo plastic surgery, it is equally important to invest time and not just money in protecting their aesthetic wellness as appropriately early as you can. As soon as a young woman’s breasts are large enough to fall off the side of their chest when they are lying down is the ideal time to prevent them from doing so!
In the same way that gravity exerts an affect on a woman’s breasts when she stands, it also profoundly affects them when she lies down. However, wearing a regular, daytime bra to bed simply did not provide the specialized support that was needed when on one’s back and side. When calling the support specialized, I am referring specifically to secure lateral outside support to keep the breasts from falling off to the side in addition to inner or middle support to prevent the upper breast from falling onto the lower during side sleeping.
There were no bras on the market that addressed these important issues. It is for that reason that I developed NightLift ®. It had to fill three criteria:1. First and foremost, it had to be comfortable, like a second skin if you will. Despite providing unparalleled support, no underwires exist within this bra.
2. It had to work. 48 prototypes were developed over several years to ensure ultimate support without wire or compression. We call this technology B.U.S.T. ® (bilateral uplift support technology).
3. It has to be stylish and sexy so a woman not only feels fabulous but also looks great, whether she’s alone or with her partner.
Whether a woman has undergone breast surgery or not, I recommend night list to all of my patients if she is concerned with aesthetic wellness of her breasts. After breast surgery (including breast augmentation, mastopexy or breast reduction) I fit my patients in NL a week after surgery when most swelling has dissipated. Since NL provides incredibly comfortable support without hurtful underwire, patients fall in love with this and it soon becomes a staple within their lingerie collection.
Randal Haworth MD
To learn more, go to Nightlift.com
The latest in treatments, fillers and procedures help keep you beautifully radiant-at any age. Here’s the inside track on what to do, and who to go to, to put your best self forward. Among those esteem practitioners interviewed by Angelina, Dr. Randal Haworth MD was honored to be included among them. Anti-aging treatments“Botox plays in important role in keeping fine lines at bay”, says plastic surgeon Dr. Randal Haworth MD renowned for achieving naturally beautiful results. Haworth suggests conservative use of Botox (from $500, the Haworth Institute) in the 30s to diminish fine lines and crows feet.
Beverly Hills plastic surgeon Dr. Randal Haworth MD Bellafill ($1200, The Haworth Institute) to permanently diminish deep folds and fill out eyelid hollows.
As busy humans striving to balance family life, successful work habits, exercise and relaxation, life can be very difficult indeed. And when these become out of balance, mental incertitude arises leading to stress and further imbalance.
It is easy to blow off exercise till another day and just curl up in front of the TV with your partner, while eating your favorite comfort foods. While this can be rewarding on the occasional night off, a pattern of this is a one way street to middle-age spread!.
For the last three years, I have been grafting certain concepts of Oriental philosophy and medicine onto my Occidental plastic surgical practice. Some of these chimeric treatments have really resonated with my patients, one especially in particular. This involves the simultaneous application of hot and cold jade stones during my administration of Botox ™(botulinum toxin type A.). Alternatively, this concept could also be used for injections of Dysport™ and Xeomen™, both new FDA approved paralytic substances for cosmetic use. I have coined Zen-Tox as a readily identifiable term describing the novel use of distraction from pain via temperature.
To read more about this unique procedure which actively decreases the discomfort experienced during facial injections, refer to Dr. Randal Haworth’s recent interview in Ocean magazine by clicking the following link.
While many surgeons feel uncomfortable with performing an upper lip lift, let alone one simultaneously with a rhinoplasty, it can be safely done. The concern revolves around the fear of losing vital blood supply to the columella (the fleshy straight partition that exists between the nostrils), because if the blood flow is compromised to this area then necrosis or loss of the columellar skin can result. This, in turn, can lead to a possible unsightly scar. If the nose job is performed through an endonasal or closed approach ( whereby all incisions are strictly confined to within the nose itself) there should be little concern for this. However, caution must be exerted when the rhinoplasty is performed with an open technique- one that involves making a scar across the columella in order to gain better access and therefore better visualization and control of the operation. In a normal open technique the incision is placed about halfway up on the columella. Since an upper lip lift necessitates making an incision at the base of the columella (where it joins with the upper lip), the incision needed for the open rhinoplasty can also be the same one- so the incision will be used for two different purposes.
Scar placement for rhinoplasty alone and in combination with an upper lip lift
The situation becomes more complicated, however, when a persisting scar stemming from a previous open nose job is present. In this situation, the plastic surgeon must carefully plan his incisions so as not to compromise the blood supply. More often than not it is safer to keep the upper lip lift incision separate from the rhinoplasty’s in these revision cases.
The planning becomes even more critical when the nostrils need to be narrowed during the nasal aesthetic surgery ( Weir excisions). Not only does the upper lip lift need to be blended well onto the columella, but it also needs to be conformed to a freshly narrowed nasal base, with minimal undesired tension across the final scar ( which can increase the chance of it being noticeable). Intricate surgery along with an intimate knowledge of the regional anatomy and the biophysics of an upper lip lift are key ingredients to a beautiful outcome in this combination surgery. Following are two examples of before and afters of this combo surgery.
Rhinoplasty is a form of nose surgery aimed at improving the shape of the nose either for aesthetic or correctional reasons. While the procedure has become quite popular in modern-day society, nose jobs are still not without risks. Without the careful supervision of a professional plastic surgeon, complications such as infection, nosebleed, or a negative reaction to anesthesia may occur.
It is important to listen carefully to the surgeon’s orders before and after the operation to minimize any post-surgical risks. Reactions to anesthesia can be prevented by avoiding certain vitamins or medication before the surgery. The doctor may also advise certain guidelines on eating drinking and smoking. To prevent any scarring or permanent spot discoloration from nose surgery, careful care must be taken while washing the face after the procedure has been administered.
At The Haworth Institute located in Beverly Hills, Dr. Randal Haworth takes great care in every aesthetic surgical procedure he administers. Learn more about how to minimize the risks of plastic surgery at DrHaworth.com. Call 310-273-3000 for inquiries.
