Augmentation Rhinoplasty and Nose Implants

Augmentation rhinoplasty, also referred to as nose lift, is nasal surgery aimed to increase the shape of the nose. This type of rhinoplasty is performed on patients of all ethnicities, though most of the patients who undergo augmentation rhinoplasty are non-Caucasian.

Augmentation rhinoplasty may boost the patient’s self-confidence and self esteem, since the nose occupies the most prominent central area on the face, greatly determining whether the face will be considered attractive or not. A higher nose bridge makes a big difference in the overall facial balance and appearance.
Augmentation rhinoplasty is sometimes deceptively conceived as a simple operation. But this is a common misconception, since placing an implant to increase the bridge of the nose is really a serious surgical interference and requires broad experience and board certification.

Any well trained and board certified rhinoplasty surgeon will explain that rhinoplasty itself is one of the most delicate cosmetic surgeries. The rhinoplasty surgeon should be able to evaluate the structure of your nasal bones and cartilage, your facial shape, your skin and your age since these are the key factors that influence his decisions on what technique is the best option for your particular case.

Augmentation rhinoplasty often makes use of grafts or implants to achieve the required changes. A graft is a medical term used to describe the material taken from your own body and transferred to another location of it. In the most cases surgeons use cartilage grafts (septal grafts) taken from inside your nose.

Sometimes the amount of material required for the desirable results is greater than the available amount of grafting material. In such cases surgeons opt for implants which are synthetic materials designed to be used in the nose. There are several implants available in the market for augmentation rhinoplasty, the most common ones are polytetrafluoroethylene (Gore-Tex), Silicone, and porous polyethylene (MedPor).
Schedule a free medical consultation with your Los Angeles rhinoplasty surgeon to clarify the further details before undergoing a nose job.

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Laser Hair Removal

1. How does laser hair removal work? Laser hair removal is the use of laser energy to produce long-term hair reduction. This is accomplished by producing heat in the hair, which is transferred to the hair follicle, which in-turn is destroyed or goes into a resting state. 2. What is a laser, really? First of all, what is a laser? A laser is a device that produces light of a single color or wavelength. In medicine, these lasers produce pulses of high-energy light that is taken up by the desired target. In the case of hair removal, the target is the black melanin pigment contained within the hair shaft. Get 30% off on ALL Laser Hair Removal* if you book an Appointment in January! Click Here to Book an Appointment or call (818)500-0823 (mention promo code: *Blogger)
A delicate balance The tricky part of laser hair removal is targeting the hair shaft without damaging the melanin pigment in the surface of the skin. Thus the laser light has to be strong enough to heat the hair, but not so strong to cause damage to the skin. In addition, the darker a patient’s skin, the more difficult it is to avoid injuring the surface of the skin while treating the hair.  Most lasers use a method of cooling the surface of the skin to avoid damage to the skin.
	When Performing Laser Hair Removal, Experience Matters Laser hair removal has been performed at Dr. Vartany’s office since 1998 with very good results with minimal adverse effects.   All laser treatments are performed by experienced Registered Nurses (RN’S) under the supervision of Dr. Vartany. We use the most up to date lasers for hair removal that are extremely effective with maximal safety and minimal discomfort.
How many treatments are necessary? Normally, a series of five to seven treatments are administered at four to eight week intervals depending upon the location of the hair. Following the initial series of treatments, subsequent treatments are administered, usually at longer and longer intervals. Some number of maintenance of treatments may be needed to keep all the hair away in a given area. After a single treatment, the hair in a given area is usually reduced in amount and thickness for a very long period of time. However, it may not be completely gone. To keep an area completely devoid of hair, maintenance treatments are always required. These maintenance treatments may eventually be required at only yearly intervals or even longer. This depends on the area being treated as well as the individual. As with any other traits in an individual, the frequency of maintenance treatments varies considerably from person to person.

*30% applies to appointments made in January. No cash value, offer may be revoked at any time.

Rhinoplasty

Rhinoplasty is a surgical procedure which is performed to improve the cosmetic appearance of one's nose. It is commonly known as "nose-job." The size and appearance of the nose are very important to the beauty of the face, and small changes in the appearance of the nose can make very large improvements in one's look. A large or wide nose takes attention away from the beauty of the eyes and the lips, and once the nose is aesthetically improved, the entire appearance of the face is drastically enhanced. A well done rhinoplasty not only improves the appearance of the face, but also improves self-confidence, self-image and sometimes even personality of the individual.

Rhinoplasty has been performed in the United States since the late 1800's and the techniques and instruments have advanced significantly over time. Modern techniques aim to achieve results that are beautiful yet natural; without interfering with the ability to breathe through nose. A small nose is not beautiful if the tip is turned up too much, the bridge is excessively reduced, the nostrils are pinched in or if the tip is abnormally narrowed. A beautiful nose should be in harmony with the rest of the face and not appear "operated." Although rhinoplasty is one of the most popular cosmetic procedures in the United States, it is also the most difficult one for a plastic surgeon to master. The delicate anatomy of the nose and the large variations in the skin type and skeletal structure of the nose make rhinoplasty a very challenging procedure to perform well. When one is considering having a rhinoplasty, one should look for a surgeon who specializes in this procedure and who has perfected his or her techniques over many years. The deformities that result from a poorly performed rhinoplasty are often very difficult to correct with additional surgery. Dr. Vartany specializes in rhinoplasty and has extensive experience in both primary and revision rhinoplasty. We invite you to view Dr. Vartany's "before and after" photos, qualifications and the testimonials from former patients prior to scheduling your consultation.

Rhinoplasty FAQ's

What is the difference between "closed" and "open" rhinoplasty?

"Open" rhinoplasty is done through an external incision on the columella of the nose which is the middle part of the nose, immediately above the lip. This results in a small external scar. "Closed" rhinoplasty on the other hand, is done entirely through internal incisions so there is no visible scar from the surgery. Dr. Vartany performs most of his rhinoplasties using the "Closed" technique.

Will my insurance pay for the procedure if I have a breathing problem?

Medical insurance can be expected to pay for non-cosmetic and medically necessary portion of the procedure. If one has difficulty breathing through one's nose due to, septal deviation for example, the septal deviation will need to be corrected at the time of the rhinoplasty and the expenses for that portion of the procedure can be billed to the medical insurance. The amount that the insurance company will pay depends on the type of coverage.

Will I be able to see what my nose will look like before having the surgery?

Yes. Dr. Vartany will take a digital picture of you and, with the aid of computer imaging, show what changes are expected from the rhinoplasty surgery. This will help both you and Dr. Vartany to determine how you will like your nose if you were to have rhinoplasty. Although the computer imaging results cannot be guaranteed, but they are usually very close to what the surgery results will be.

What kind of anesthesia will I have?

Dr. Vartany performs rhinoplasty under general anesthesia which will be administered by a Board Certified Anesthesiologist in a fully accredited surgical center. You will be completely asleep during the procedure and you will not feel or hear anything.

How long does the surgery take?

It usually takes about two and a half hours for the surgery. You will arrive one hour prior to the surgery and a go home about an hour after the surgery ends.

How is the recovery after rhinoplasty?

You will need to have about 10 days off from work or school for this procedure. When you wake up from anesthesia you will have a splint on your nose and develop some bruising and swelling under the eyes. The splint is removed one week after the surgery and the bruising takes another few days to resolve. There is very little pain after rhinoplasty. There is usually some discomfort from stuffiness and pressure sensation of the nose. Dr. Vartany does not use nasal packing, so you will be able to breathe through your nose immediately after the surgery to a certain extent. You will have prescription pain medication to take if that becomes necessary, however try to minimize the taking of the pain medications because they can cause nausea or constipation.

What can be done to minimize the bruising?

Dr. Vartany uses very delicate techniques during the procedure to minimize the bruising and swelling after the surgery. You will also be asked to stop taking any Aspirin or Motrin for one week prior to the surgery because these medications increase the bruising. Placing cold compresses on the eyelids after the surgery also decreases the amount of swelling and bruising. Taking Arnica, an herbal medication, may help resolve the bruising faster. This herbal medication will be given to your prior to your surgery.

When will I see the final appearance of my nose?

It takes about a year for the swelling of the nose to resolve after rhinoplasty. When the splint is removed from the nose seven days after surgery, the nose is very swollen and people often feel that their nose is wider than before the surgery. This excessive swelling reduces over the first three weeks after surgery and the remaining swelling, especially of the tip, takes at least a year to completely resolve.

Brow Lift FAQ

	Enhancing your appearance with a brow lift What to expect during your consultation Preparing for surgery Procedural Steps Important facts about the safety and risks of brow lift surgery My recovery The results will be long-lasting Words to know
	Also known as a forehead lift, a brow lift minimizes the creases that develop across the forehead, or those that occur high on the bridge of the nose; improves what are commonly referred to as frown lines; and repositions a low or sagging brow.
	Enhancing your appearance with a brow lift
	If you are bothered by expression lines or other signs of aging in the brow region, a brow lift may be right for you. A brow lift:
	Minimizes the creases that develop across the forehead, or those that occur high on the bridge of the nose, between the eyes   Improves what are commonly referred to as frown lines, vertical creases that develop between the eyebrows   Repositions a low or sagging brow that is hooding the upper eyelid   Raises the eyebrows to a more alert and youthful position Rejuvenation procedures typically performed in conjunction with a brow lift include:   Eyelid surgery to rejuvenate aging eyes   Facelift to correct aging changes in the mid- to lower face and neck regions   Skin resurfacing techniques
	Is it right for me?
	A brow lift is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Brow lift surgery is a good option for you if:   You are physically healthy   You don’t smoke   You have a positive outlook and specific, but realistic goals in mind for the improvement of your appearance
	What to expect during your consultation
	The success and safety of your brow lift procedure depends very much on your complete candidness during your consultation. Dr. Vartany will ask you questions about your health, desires and lifestyle.  He will also show you before and after pictures of the procedures that he has performed. Be prepared to discuss:   Why you want the surgery, your expectations and desired outcome   Medical conditions, drug allergies and medical treatments   Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs   Previous surgeries Dr. Vartany will also:   Evaluate your general health status and any pre-existing health conditions or risk factors   Discuss the options available to you for facelift and facial rejuvenation   Examine and measure different parts of your face   Take photographs for your medical record   Discuss your options and recommend a course of treatment   Discuss likely outcomes of a brow lift and any risks or potential complications
	Preparing for surgery
	Prior to surgery, you may be asked to:
	Get lab testing or a medical evaluation   Take certain medications or adjust your current medications   Stop smoking well in advance of surgery   Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
	Special instructions you receive will cover:
	What to do on the night before and morning of surgery   The use of anesthesia during your brow lift   Post-operative care and follow-up Dr. Vartany will also discuss where your procedure will be performed. A brow lift may be performed in an outpatient surgical center, or a hospital.
	Procedural Steps:
	What happens during brow lift surgery?
	Step 1 - Anesthesia
	General anesthesia is used for the surgery and it will be administered by a board certified anesthesiologist.
	Step 2 – The incisions
	A brow lift may sometimes be performed using an endoscope (surgical video device) and special instruments placed through small incisions made within the hairline. This allows the tissue and muscle beneath the skin to be repositioned, altered or removed, correcting the source of visible creases and furrows in the forehead. Correction of a low-positioned or sagging brow may be made with or without the use of an endoscope through incisions at the temples and in the scalp. This technique may be done in conjunction with incisions hidden within the natural crease of the upper eyelids to eliminate frown lines between the brows, on or above the bridge of the nose. An alternative brow lift technique is the coronal brow lift. The coronal brow lift can pinpoint specific regions of the brow to correct. This technique involves an incision from ear to ear, lifting the forehead and removing excess skin from the scalp. Recovery time is often longer than the endoscopic brow lift due to the size of the incision. The incision lines from a brow lift are well concealed within the hair or natural contours of the face unless they are placed at the hairline to shorten the forehead. Results appear gradually as swelling and bruising subside to reveal smoother forehead skin and a more youthful, restful appearance. Brow elevation may be maintained by the use of:   Permanent sutures   Small surgical screws   Absorbable fixation device placed inconspicuously at the temples
	Step 3 –Closing the incisions
	Brow lift incisions typically are closed with special clips
	Step 4 - See the results
	Important facts about the safety and risks of brow lift surgery
	The decision to have a brow lift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Dr. Vartany 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 and potential complications.
	The risks include:
	Unfavorable scarring   Bleeding (hematoma)   Infection   Poor wound healing   Anesthesia risks   Blood clots   Correctable hair loss at the incisions   Elevated hairline   Facial nerve injury with weakness or paralysis   Facial asymmetry   Skin loss   Numbness or other changes in skin sensation or intense itching   Changes in skin sensation   Eye irritation or dryness   Eyelid disorders that involve abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can coexist with sagging forehead and eyebrow structures; brow lift surgery will not correct these disorders; additional surgery may be required     Fluid accumulation   Pain, which may persist   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
	When you go home
	If you experience shortness of breath, chest pains, or unusual heart beats, call Dr. Vartany immediately. Should any of these complications occur, you may require hospitalization and additional treatment. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.
	My recovery
	When your procedure is completed, your forehead may be taped and your head may be loosely wrapped to minimize swelling and bruising. A thin tube may be present to drain any excess blood or fluid that may collect under the skin.
	The results will be long-lasting
	Initial wound healing may take 5 to 10 days, at which time any sutures or clips will be removed. You will be ready to return to work and normal activity at this time. Cosmetics can camouflage any bruising that remains. Healing will continue for several weeks as the swelling dissipates and incision lines refine and fade and it may take several months for your complete recovery.
	Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance.
	Words to know
	Brow lift: A surgical procedure to correct a low-positioned or sagging brow. Smooths furrows across the forehead and between the brows.   Endoscope: A surgical video device sometimes used during brow lift procedures.   General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.   Hematoma: Blood pooling beneath the skin.   Intravenous sedation: Sedatives administered by injection into a vein to help you relax.   Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.   Skin resurfacing: Treatment to improve the texture, clarity and overall appearance of your skin.   Sutures: Stitches used by surgeons to hold skin and tissue together.
	Excerpted from the ASPS/ASAPS Patient Education Brochures