CHIN IMPLANT 

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If you feel that your chin is not in proportion to the rest of your face, an implant can help to build out a recessive chin and improve the appearance of your facial features. Chin implants are sometimes performed at the same time as another operation to re-shape the face, such as a facelift. 
Recessive chins are built out either by moving the chin forwards or by inserting an implant over the chin bone. During the operation your plastic surgeon will usually make a cut inside your mouth between your lower lip and gum and insert an implant to move your chin forward. In some cases your consultant may advise that the implant is inserted through a cut in the natural crease of your chin. The implant is usually made of silicone or another manufactured material, although sometimes it is necessary to use a bone graft. 
Because the implant is inserted through the mouth, there is not usually a visible scar. However, if a bone graft is used there will be scarring in the area the graft is taken from - usually the hip - and your consultant surgeon will discuss this with you prior to your operation. 
 
Chin implant surgery is performed under a general anaesthetic and you'll usually be in hospital for one day. You'll also need to plan time off work to rest and recover. 
 
All operations carry risks as well as benefits. The chance of complications following a chin implant depends on the type of operation and other factors such as your general health. Your plastic surgeon will explain how the risks apply to you. 

NOSE - RHINOPLASTY 

Rhinoplasty, or surgery to reshape the nose, is one of the most common of all plastic surgery procedures. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. Sometimes the septum needs reshaping and this is called a septo- rhinoplasty. It may also correct a birth defect or injury, or help relieve some breathing problems. 
If you're considering rhinoplasty, this information will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand. 

THE BEST CANDIDATES FOR RHINOPLASTY 

Rhinoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon. 
 
The best candidates for rhinoplasty are people who are looking for improvement, not perfection, in the way they look. If you're physically healthy, psychologically stable, and realistic in your expectations, you are likely to be a good candidate. 
Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes-to correct birth defects or breathing problems. 
 
Age may also be a consideration. Many surgeons prefer not to operate on teenagers until after they've completed their growth spurt-around 14 or 15 for girls, a bit later for boys. It's important to consider teenagers' social and emotional adjustment, too, and to make sure it's what they, and not their parents, really want. 

ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK 

In our patient series, any complications tend to be infrequent and minor. Bleeding, infection, or a reaction to the anesthesia is very unusual. You can reduce your risks by closely following your surgeon's instructions both before and after surgery. 
 
As for scarring, when rhinoplasty is performed from inside the nose, there is no visible scarring at all; when an "open" technique is used, or when the procedure calls for the narrowing of flared nostrils, the small scars on the base of the nose tend to blend in and become indistinct. 
 
In less than one case out of ten, a second procedure may be required-for example, to correct a minor deformity. Such cases are unpredictable and happen even to patients of the most skilled surgeons, and fortunately the corrective surgery is usually minor. 
Your surgeon will also explain the techniques and anesthesia he or she will use, the type of facility where the surgery will be performed, the risks and costs involved, and any options you may have. Most insurance policies don't cover purely cosmetic surgery; however, if the procedure is performed for reconstructive purposes, to correct a breathing problem or a marked deformity, the procedure may be covered. Check with your insurer, and obtain pre-authorization for your surgery. 
 
Be sure to tell your surgeon if you've had any previous nose surgery or an injury to your nose, even if it was many years ago. You should also inform your surgeon if you have any allergies or breathing difficulties; if you're taking any medications, vitamins, or recreational drugs; and if you smoke. 
 
Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results. 
PREPARING FOR YOUR SURGERY 
 
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. Carefully following these instructions will help your surgery go more smoothly. 
 
While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed. 
 
Your surgeon will also explain the techniques and anesthesia he or she will use, the type of facility where the surgery will be performed, the risks and costs involved, and any options you may have. Most insurance policies don't cover purely cosmetic surgery; however, if the procedure is performed for reconstructive purposes, to correct a breathing problem or a marked deformity, the procedure may be covered. Check with your insurer, and obtain pre-authorization for your surgery. 
 
Be sure to tell your surgeon if you've had any previous nose surgery or an injury to your nose, even if it was many years ago. You should also inform your surgeon if you have any allergies or breathing difficulties; if you're taking any medications, vitamins, or recreational drugs; and if you smoke. 
 
Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results. 
WHERE YOUR SURGERY WILL BE PERFORMED 
 
Rhinoplasty must be performed in a known private hospital that deals with general surgical care and not a commercial clinic posing as a hospital or a surgeon's office-based facility. It's usually done on an inpatient basis, for a one night stay. 
Many plastic surgeons perform rhinoplasty from within the nose, making their incision inside the nostrils. Others prefer an "open" procedure, especially in more complicated cases; they make a small incision across the columella, the vertical strip of tissue separating the nostrils. 
 
When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages. 
GETTING BACK TO NORMAL 
 
Most rhinoplasty patients are up and about within two days, and able to return to school or sedentary work a week or so following surgery. It will be several weeks, however, before you're entirely up to speed. 
 
Your surgeon will give you more specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions: Avoid strenuous activity (jogging, swimming, bending, sexual relations-any activity that increases your blood pressure) for two to three weeks. Avoid hitting or rubbing your nose, or getting it sunburned, for eight weeks. Be gentle when washing your face and hair or using cosmetics. 
 
You can wear contact lenses as soon as you feel like it, but glasses are another story. Once the splint is off, they'll have to be taped to your forehead or propped on your cheeks for another six to seven weeks, until your nose is completely healed. 
 
Your surgeon will schedule frequent follow-up visits in the months after surgery, to check on the progress of your healing. If you have any unusual symptoms between visits, or any questions about what you can and can't do, don't hesitate to call your doctor. 
PREPARING FOR YOUR SURGERY 
 
Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. 
 
While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed. 
 
TYPES OF ANAESTHESIA 
 
Rhinoplasty can be performed under a general anesthesia so you'll sleep through the operation. 
 
You'll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. Applying cold compresses will reduce this swelling and make you feel a bit better. In any case, you'll feel a lot better than you look. Most of the swelling and bruising should disappear within two weeks or so. (Some subtle swelling-unnoticeable to anyone but you and your surgeon-will remain for several months.) 
 
A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. Your surgeon will probably ask you not to blow your nose for a week or so, while the tissues heal. 
 
If you have nasal packing, it will be removed after a few days and you'll feel much more comfortable. By the end of one or, occasionally, two weeks, all dressings, splints, and stitches should be removed. 
ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK 
 
Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure, these will be discussed at your consultation 
EYEBAGS, RHINOPLASTY, CHIN IMPLANT 
Carole my splint is off! ….Mr Peart is a genius I am so thrilled with my new face it has far exceeded my expectations. 
I feel fantastic..thank you so much it was all so smooth and straight forward. 
 
Thank you both! 
 
MRS D. BIRMINGHAM 
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