Facial Plastic and Reconstructive Surgery

Aesthetic, functional, and reconstructive surgery of the face and neck.

Rhinoplasty

A cosmetic rhinoplasty is designed to alter the shape of the nose, bringing the different parts of the nose in harmony with the rest of the face. As a central feature of the face, the nose has a significant effect on the overall appearance. A crooked nose, a prominent hump, bulbous tip, or asymmetries can distract from facial harmony and draw undue attention to the nose. The rhinoplasty consult will begin with a thorough history and physical exam by the physician. Photography will be used to further define the goals of treatment and demonstrate potential changes to the shape of the nose.

Revision Rhinoplasty

Some patients seek treatment to correct changes created in a prior nose surgery. Certain cardinal signs of a prior nose surgery can include a pinched nasal tip, arched nostrils, a droopy tip, collapsed nose or even prominent nasal bones. These features may not have been noticed immediately after surgery, but may have developed as the nose healed and as the swelling in the nose resolved. These problems are frequently caused by removing or weakening the structural support of the nose in the prior surgery and can be corrected surgically by strengthening the nasal support. Often revision rhinoplasty takes longer and may require additional material to create the support.

Functional Rhinoplasty

The nose should provide a clear passageway for easy nasal breathing and smelling. When patients present to the office with difficulty breathing, the physician must consider all the factors that may be contributing to this issue. Typically, this can be divided into two parts: problems created by swelling in the nose, and problems created by a narrow anatomic passageway. Only with a thorough history and physical exam can the physician determine the source of the problem and then offer appropriate treatment.

Some patients have difficulty breathing through the nose because of swelling of the specialized skin (mucosa) inside the nose. This can be influenced by many different factors including allergy and environmental irritants. Treatment may include medicine, nasal sprays and even allergy desensitization.

When discussing breathing trouble caused by a narrowed nasal passage, there is much emphasis on nasal septal deviation. This is common and may be a factor, but frequently is only one of many factors. Another common reason why a nose may be blocked is if there is insufficient support in the nasal valve areas. The nasal valves are the narrowest areas in the nose and can be prone to collapse. Although the nostrils may be of sufficient size at rest, with a moderate inspiration of air, the nose may collapse. This indicates that there is not enough support in the nose and is best diagnosed with a physical exam. This weak, collapsing area can be corrected using surgical techniques that strengthen the nasal support.

Many patients have several contributing factors leading to nasal obstruction and the best treatment may include both medical therapy and surgery.

Chin Implant

One of the most common surgical procedures performed with rhinoplasty is chin augmentation. When a chin is undersized, the nose will appear larger and more prominent. By bringing the chin into proper proportion with the nose, cheeks and brow, the face will obtain improved overall harmony. When appropriate, liposuction on the neck can further improve the facial contours by creating a more crisp jaw line and better profile.

Facial Rejuvenation

As the face ages, certain characteristic changes occur. The skin loosens and some of the youthful fat descends and shrinks. The face begins to take on a more rectangular appearance as jowls develop and the skin under the neck sags. The physicians at Otosurgical utilize the entire spectrum of treatment options to reduce the signs of aging and turn back the clock. We strive for a natural, un-operated appearance using techniques proven to have predictable and long-lasting results.

Otoplasty

Prominent or asymmetric ears can negatively affect the appearance. For school aged children it can also lead to embarrassment and significant ridicule by peers. Minimally invasive techniques can be used to improve the contours of the ear using sutures (stitches) buried under the skin. These permanent stitches create long lasting improvement in shape and symmetry.

Reconstructive Surgery

Patients are often sent to Otosurgical for repair after skin cancer removal. Many techniques are available, and the physician will discuss all treatment options. Some techniques are best performed in several stages and the physician will describe the course of treatment. The ideal technique will be selected based on the size and location of the defect, as well as the wishes of the patient.

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