Naturally, patients should choose a doctor who has a good reputation for success. Individuals should ask friends, family, and general practitioners for recommendations. Additionally, all state medical boards are required to make a doctor's information public. Patients may access these records to look for any past lawsuits or infractions. In many areas, these records are available online, but in some states, they can only be accessed through the mail.
Very slight changes to the structure of your nose — often measured in millimeters — can make a large difference in how your nose looks. Most of the time, an experienced surgeon can get results both of you are satisfied with. But in some cases, the slight changes aren't enough, and you and your surgeon might decide to do a second surgery for further changes. If this is the case, you must wait at least a year for the follow-up surgery, because your nose can go through changes during this time.
Secondary rhinoplasty differs from the primary procedure in that it may require cartilage or bone grafting. If too much tissue or bone was removed in the first surgery, the doctor will need to replace this in order to achieve the desired look. Often, cartilage is taken from the ear or other areas of the nose. In rare cases, it is harvested from a rib, in what is known as a costal cartilage graft.
There are other pricing factors to consider as well such as the extent of your procedure, where you live, and the plastic surgeon you choose. For example, slight surgical reshaping of the nose requires less surgical time (and therefore has a lower price tag) than a complete change in shape. In general, a longer or more complicated procedure will be more expensive. This is especially true if your situation requires an overnight stay, although most rhinoplasty procedures are performed as outpatient procedures. Revision rhinoplasty (performed on patients who have had a nose surgery in the past) tends to be more complicated, and therefore costlier, than an initial procedure.
Breast reconstruction may be performed after mastectomy, to rebuild injured or congenitally deformed breasts, or as part of gender reassignment surgery. As part of the reconstruction process, a breast tissue expander may be used to stretch the patient's tissue for insertion of an implant or the patient's own tissue. Tissue expanders are like thick-walled silicone balloons, come in different sizes and shapes, and may have a smooth or textured outer surface. They are implanted under the breast skin, tissue, or chest muscle, and are regulated by the FDA as medical devices. In immediate reconstruction, the expander is inserted immediately following mastectomy. For patients who choose delayed reconstruction, the expander is implanted in a separate surgery months or years later.
Open rhinoplasty gives the surgeon greater access to the cartilage and bone of the nose but it will leave some scar tissue. By creating an incision across the columella (the area of cartilage between the two nostrils) the doctor can lift the skin off the tip of the nose and shape the cartilage very precisely. When healed, the incision leaves a very small, almost negligible scar on the underside of the nose.
At the same time, patients will also need to avoid certain foods and supplements, which could slow healing and cause surgical complications. In particular, patients should steer clear of vitamin E supplements, ginger, gingko, and ginseng. Some homeopathic and herbal supplements can cause complications with anesthesia, so patients should check with their doctors before taking additional nutrition.
For large or extra large implants, saline implants go up to 800cc, but we can overfill them up to 1400cc or larger. When a patient wants extra large breast implants, staging the procedures may be necessary by starting with the maximum size the tissues will allow, then undergoing a second surgery after the tissues have stretched to accommodate larger implants.