Introduction
Nose dorsum repair is a crucial surgical procedure, whether for addressing functional issues or enhancing aesthetic appearance. In New York City, a bustling metropolis known for its top - notch medical facilities and world - renowned surgeons, netizens have shown a keen interest in certain hospitals and experts for nose dorsum repair. This article will explore the key institutions and surgeons in New York City that are popular among the public for this type of surgery, along with detailed information about the procedures, considerations, and patient experiences.
Understanding Nose Dorsum Repair
Common Reasons for Nose Dorsum Repair
The nose dorsum can be affected by various factors, leading to the need for repair. Some of the common reasons include:
- Trauma: Accidents such as falls, sports injuries, or physical assaults can cause fractures or other damage to the nose dorsum, resulting in deformities and potentially affecting breathing.
- Congenital Deformities: Some individuals are born with nasal dorsum irregularities, like a saddle nose deformity or a prominent dorsal hump. These can have an impact on both the appearance and self - esteem of the patient.
- Previous Nasal Surgery Complications: Botched previous rhinoplasties or other nasal surgeries can lead to issues with the nose dorsum that require corrective procedures.
Types of Nose Dorsum Repair Procedures
There are several types of procedures used for nose dorsum repair, each tailored to the specific needs of the patient:
| Procedure | Description |
|---|---|
| Rhinoplasty | This is a comprehensive nose surgery that can address both functional and aesthetic issues of the nose dorsum. It may involve modifying the bone and cartilage of the nasal framework, reshaping the tip, and improving the overall balance of the nose. |
| Cartilage Grafting | Cartilage from the ear, rib, or other sources can be used to augment or support the nose dorsum. This is often used in cases of saddle nose deformity or when additional structural support is needed. |
| Bone Grafting | Bone grafts, typically from the skull, can be used to correct severe bone loss or deformation in the nose dorsum. |
| Injectable Fillers | For minor irregularities, injectable fillers can be used to temporarily smooth out the nose dorsum. However, this is a non - permanent solution. |
Top Surgeons and Hospitals in New York City for Nose Dorsum Repair
Dr. Maurice M. Khosh
Expertise in Saddle Nose Repair
Dr. Khosh is highly experienced in treating patients with saddle nose deformity. Saddle nose deformity or nasal dorsum collapse is an uncommon but severe condition that may require complex reconstruction. It can be caused by various factors such as nasal trauma, previous nasal surgery, autoimmune disorders (e.g., Wegener’s granulomatosis, relapsing polychondritis), and the sniffing of recreational drugs. Before performing the repair, Dr. Khosh takes the time to establish and treat the underlying cause of the nasal collapse, which may involve biopsies, blood tests, or consultations with specialists.
Treatment Approaches
He is well - versed in all techniques for saddle nose reconstruction, including filler injections, cartilage grafts from the ear and the rib, bone grafts from the skull, and manufactured implants. Dr. Khosh tailors the reconstructive options and the approach (open rhinoplasty vs. closed rhinoplasty) to the extent of the deformity and the underlying cause of the collapse. For example, in the case of a 17 - year - old girl with saddle nose deformity due to Wegener’s granulomatosis, her nasal reconstruction entailed cartilage grafting from the rib through an open rhinoplasty approach.
Patient Consultation
Patients seeking consultation for saddle nose deformity are encouraged to bring photographs that display their nose in its healthy state, prior to collapsing. During the consultation, Dr. Khosh uses computer imaging to clearly communicate and discuss the intended outcome from nasal reconstruction. He also thoroughly discusses the treatment options and the benefits and shortcomings of each choice.
FAQs Answered by Dr. Khosh
- Insurance Coverage: Most insurance companies consider the surgical repair of a saddle nose deformity to be reconstructive rather than cosmetic and therefore cover the costs of surgery.
- Rib Cartilage Grafting: A one - to - two - inch incision in the crease below the breast allows access for removal of a piece of rib cartilage. The incision site is closed meticulously, and the scar is barely perceptible. Pain and discomfort resolve in approximately 10 days.
- Ear Cartilage Harvest: He harvests ear cartilage through an incision behind the ear. Cartilage harvest is confined to the concave central aspect of the auricle, and there will be no change to the appearance or function of the ear. The incision site is completely hidden.
- Surgery Duration: Although each case is unique, the average duration of surgery for saddle nose deformity is 3.5 hours.
- Hospital Stay: In surgical procedures where rib cartilage was used for repair of a saddle nose, patients typically stay in the hospital for one night. Other modalities of saddle nose repair are performed as outpatient surgeries, and patients can go home after surgery.
- Nasal Packing: No packing is used inside the nose following saddle nose repair.
Mount Sinai - New York
Comprehensive Rhinoplasty Services
At Mount Sinai’s division of facial plastic and reconstructive surgery, the goal of rhinoplasty is to create natural, long - lasting results that improve the shape, size, and distinction of the nose. The facial plastic surgeons at Mount Sinai are double - board - certified in facial plastic and reconstructive surgery and otolaryngology (ear, nose, and throat). Their vast expertise in nasal function, as well as nasal and facial aesthetics, ensures that patients' new noses not only look better but also breathe better.
Types of Rhinoplasty
They perform both closed/endonasal (without an external incision) and open/external rhinoplasty. The choice of approach depends on the patient's unique anatomy and functional and aesthetic goals. For primary rhinoplasty, it is performed for the first time to address cosmetic concerns and/or nasal breathing. Revision rhinoplasty is done to address concerns or deformities resulting from prior nose surgeries.
Multidisciplinary Approach
Mount Sinai patients have access to a wide range of specialists and subspecialists. For patients with specific concerns related to their nasal breathing, nasal allergies, sinus disease, or deformity after cancer treatments, the hospital works closely with its widely recognized experts in the division of rhinology and sinus surgery and the head and neck institute. Combined surgeries can even be performed when appropriate.
Adolescent Rhinoplasty Considerations
Rhinoplasty is a common procedure among teenagers and youth. However, if a nose job is for cosmetic reasons, girls should wait until around age 15 (after puberty) and boys until 17 or 18 years or older when their nasal bone has reached its adult size. If the surgical procedure is to correct a breathing problem or repair the bone after an injury, it can be performed before the patient is fully grown.
Before and After Surgery Care
Patients start with an extensive consultation to identify areas of concern and review their goals. Surgeons then develop an individualized treatment plan. Rhinoplasty surgery is usually performed in an outpatient setting under general anesthesia or with a combination of local anesthesia and sedation. After surgery, patients are given a short course of antibiotics and mild pain medication. The majority of swelling subsides within the first two weeks, although it may take up to a year for all the swelling to fully fade. Patients are expected to return to work or school within one to two weeks after surgery and should avoid strenuous activities for two weeks after surgery.
Dr. David Cangello
Expertise in Rhinoplasty
Dr. Cangello is a board - certified plastic surgeon who is highly specialized in rhinoplasty. He understands that the nose should naturally complement the facial shape and features. Whether the treatment is for cosmetic or functional purposes, Dr. Cangello uses his expert surgical skill and artistic vision to reshape the nose to blend seamlessly with other facial features.
Unique Techniques
He is a pioneer in preservation rhinoplasty, a technique that allows him to preserve as much of the patient's natural bone structure, cartilage, and tissue while reducing bumps and humps. Results are refined and natural - looking with the potential for a quicker recovery than with traditional rhinoplasty. Dr. Cangello also offers scarless rhinoplasty, also known as closed rhinoplasty. This surgical technique is indicated for patients who want to change the appearance of their nose without the use of external incisions. Modifications that can be made through scarless rhinoplasty include reducing a dorsal hump, de - projecting an over - projected nose, refining a bulbous or boxy nasal tip, etc.
Open vs. Closed Rhinoplasty Philosophy
One of the large debates in rhinoplasty is the choice between the closed and open approaches. Dr. Cangello often begins with a closed approach. He believes that through the closed approach, he can modify the dorsum and tip and see the effects of the changes made instantaneously. Additionally, certain ligamentous structures which provide support to the tip are maintained. His approach is also minimally traumatic, resulting in minimal swelling and usually no bruising, which leads to a much quicker recovery. However, he also acknowledges that the scar from the open approach is essentially inconsequential if the surgeon is meticulous, and he may use the open approach when necessary.
Patient Selection and Expectations
Ideal candidates for rhinoplasty with Dr. Cangello are men and women who are in good health but unhappy with the appearance of their nose, whether due to cosmetic imperfection after an injury, breathing problems, or dissatisfaction with the size or shape of the nose. It's important for patients to have reasonable and optimistic expectations about their outcome from nose surgery, as the best results are achieved when the shape of the nose is enhanced within the limits of their own anatomy and facial proportions.
Dr. Joseph Rousso
Specialty in Nasal Reconstruction
Dr. Rousso is one of the top facial plastic and reconstructive surgeons in New York City, with world - wide experience in reconstructive facial surgery. His primary specialties include rhinoplasty and facial reconstruction, which are crucial for nasal reconstruction. The nose is vulnerable to trauma, and some nose traumas can deform both the appearance and impact the function of the nose. Dr. Rousso's expertise and skill can achieve functional airway reconstruction of the nasal passages, as well as address aesthetic concerns for the patient.
Reconstructive Rhinoplasty Approach
Unlike cosmetic rhinoplasty, nasal reconstruction often involves more biological and medical issues, such as rebuilding lost or damaged tissues including skin, bone, and cartilage grafts, depending on the extent of the injury. Dr. Rousso aims to achieve both biological function and aesthetic form with every reconstructive rhinoplasty procedure he performs, giving patients a beautiful, balanced, and functional nose after severe trauma.
Dr. Joshua D. Zuckerman
Nasal Fracture Repair
Dr. Zuckerman is a distinguished broken nose plastic surgeon based in the upper east side. Nasal fractures, commonly referred to as broken noses, require precise treatment to prevent long - term cosmetic and breathing issues. He offers expert nasal fracture repair to restore both function and aesthetics to the nose.
Benefits of Choosing Dr. Zuckerman
There are several reasons to choose Dr. Zuckerman for nasal fracture repair. His deep understanding of facial anatomy allows for precise corrections that respect both the aesthetic and functional aspects of the nose. He tailors surgical plans to meet individual needs and expectations. Also, he utilizes the latest in surgical technology and methods, ensuring minimal scarring and optimal outcomes.
Procedure and Recovery
During the initial consultation, Dr. Zuckerman evaluates the extent of the nasal injury through physical examination and imaging tests if necessary. The nasal fracture repair is typically performed under general anesthesia, where he carefully realigns the bones and, if needed, the cartilage. A septoplasty might be performed concurrently if the nasal septum is deviated. After surgery, patients may experience swelling and bruising around the nose and under the eyes, which generally improve within two weeks. He provides comprehensive postoperative care instructions to help manage discomfort and support healing, including avoiding strenuous activities, keeping nasal splints or packing in place as instructed, and attending regular follow - up visits.
Patient Considerations Before Nose Dorsum Repair
Research and Consultation
Before undergoing nose dorsum repair, patients should conduct thorough research on different surgeons and hospitals. Reading patient reviews, looking at before - and - after photos, and seeking recommendations from trusted sources can provide valuable insights. It's also essential to schedule consultations with multiple surgeons to discuss the procedure, expected outcomes, and potential risks. During the consultation, patients should ask questions about the surgeon's experience, the specific techniques they will use, and the estimated cost of the surgery.
Realistic Expectations
Patients need to have realistic expectations about the results of nose dorsum repair. While surgery can significantly improve the appearance and function of the nose, it may not completely transform it into an idealized version. The final outcome is influenced by the patient's existing anatomy, and the surgeon can only work within certain limitations. Understanding this can help patients avoid disappointment after the surgery.
Health and Lifestyle Factors
Patients should be in good overall health before undergoing nose dorsum repair. Certain health conditions, such as diabetes, high blood pressure, or autoimmune disorders, may affect the surgical outcome and recovery process. Surgeons may require patients to have a pre - operative medical evaluation to assess their health status. Additionally, lifestyle factors such as smoking can negatively impact wound healing and increase the risk of complications. Patients are usually advised to quit smoking before the surgery.
Conclusion
In New York City, there are several highly skilled surgeons and reputable hospitals that have been selected by netizens for nose dorsum repair. Surgeons like Dr. Maurice M. Khosh, Dr. David Cangello, Dr. Joseph Rousso, and Dr. Joshua D. Zuckerman, along with institutions such as Mount Sinai, offer a wide range of expertise and treatment options for various nose dorsum issues. Patients considering nose dorsum repair should take the time to research, consult with multiple experts, and have realistic expectations. By doing so, they can increase the chances of a successful surgery and achieve the desired results.
If you're interested in learning more about nose dorsum repair or scheduling a consultation with one of the surgeons mentioned in this article, reach out to the respective hospitals or surgeons' offices. Share this article with others who may be considering nose dorsum repair to help them make informed decisions.
