Kristen Yee, MD

Fillers would camouflage the depression in your nasal tip, which is due to a gap between the cartilages over each nostril.  If you're also concerned about the width of the tip of your nose, and the angle of your nasal tip, the fillers won't really address that; surgery would be best to bring those two cartilages together, which will eliminate the gap ("gash"), narrow the tip of your nose, and at the same time the tip can be rotated down.  I advise you to find someone specifically trained in facial aesthetic surgery who is board certified, who does fillers as well as nasal surgery (rhinoplasty) so that they have the experience to treat you whatever you decide.  


Best wishes!

A board-certified plastic surgeon is the best practitioner to harvest the fat from liposuction, and then I recommend you find someone who does a lot of facial surgery, not just liposuction.  For example, I am trained in craniofacial surgery, which is an additional year of training after plastic surgery training focused on treating congenital and traumatic facial deformities, as well as aesthetic facial surgery, so I am very comfortable with safely injecting into the face and planning the best areas to fill for a natural look.  

Fat grafting sometimes has unpredictable take, as you already know, so it's best to start conservatively and then add as needed.  What you do have, after 3-6 months, will be permanent.  I do mention being conservative especially because the fat will behave like the area it came from - that is, if it's taken from your thigh, and you gain weight, that area of your face will also plump up a bit, which may or may not be what you want!  (This is more of an issue in kids, if they've had fat grafting before puberty, but it's a consideration)

Good luck!

That is a great question.  One way to test out how you might look without the implants is to have the implants punctured with a needle (by a surgeon), to mimic a rupture, and then typically your body just reabsorbs the saline.  Usually the implant will go down (and of course this is not reversible!) and then you can get a good idea of what will happen, if your implants are removed and you don't have a lift.  This procedure has helped my patients make their decision.

Your results also depend on how big your implant is, in relation to your remaining breast tissue.  In some women who have thinned out breast tissue over larger implants, a lift to rearrange the remaining tissue and remove some of the loose skin can look much better than without.

Compression garments can help somewhat but can't address all excess skin, and unfortunately exercise can't help.  

Good luck!

Scars continue to mature over the first year, so you're still in a good window!  Massage always helps, and you can use any simple lotion or oil (like Eucerin, or fragrance-free massage oil) to make it easier.  The other item I always suggest is Mederma, which is also available at drugstores.  It is the only topical treatment that has been shown to improve scars.  Just follow the directions on the package, some forms have a gel, a lotion, or a dressing; any of these is fine.

Good luck!

When I do a breast reduction, or do a breast lift, I always use internal sutures to bring the tissue higher on the chest wall to create more fullness on top.  Compared to the use of an implant, however, your own tissue will probably not look as round and high as an implant can, because it responds to gravity differently than an implant.  It would be good to find reference photos so you can discuss your goals with your surgeon and she or he can compare those to where you are now, to come up with a plan to achieve your goals.  

Best wishes!