Introduction
The nasal columella is a crucial part of the nose, playing a significant role in determining the projection of the nasal tip, defining the nasolabial angle, and influencing the relationship between the nasal base and alar rims. Strengthening the nasal columella support structure is often an important aspect of rhinoplasty and other nasal reconstruction procedures. In New York City, there are numerous professionals with varying degrees of expertise in this area. This article aims to present the top five professionals ranked for their proficiency in strengthening the nasal columella support structure in 2025.
Importance of Nasal Columella Support Structure
The nasal columella not only contributes to the aesthetic appearance of the nose but also has functional implications. It marks the transition from non - keratinizing squamous epithelium to respiratory ciliated columnar epithelium and provides support to the nasal tip. During rhinoplasty, the columella structure is often compromised, and reconstructing it is essential for long - lasting positive outcomes. For example, proper columella support can help maintain the shape and position of the nasal tip, preventing it from drooping over time. Additionally, a well - supported columella can enhance nasal function by ensuring proper airflow.
Evaluation Criteria for Ranking
To compile the top five list, several factors were considered:
- Professional Qualifications: This includes board certifications, educational background, and specialized training in nasal surgery and reconstruction. For instance, surgeons who are double - board certified in facial plastic and reconstructive surgery and head and neck surgery often have a broader range of skills and knowledge.
- Clinical Experience: The number of years of experience performing procedures related to nasal columella support, as well as the volume of cases, was taken into account. More experienced surgeons are likely to have encountered a wider variety of cases and developed effective techniques.
- Patient Outcomes: The quality of results, patient satisfaction, and the ability to achieve natural - looking outcomes were significant factors. This was evaluated through patient testimonials, before - and - after photos, and reviews.
- Innovation and Research: Professionals who have contributed to the field through research, the development of new techniques, or the improvement of existing methods were given extra consideration. For example, those who have published research on optimizing columellar strut dimensions or innovative reconstruction techniques.
- Reputation in the Medical Community: Recognition from peers, awards, and memberships in prestigious medical organizations also played a role in the ranking.
The Top Five Professionals in New York City
1. Dr. Andrew Jacono
Qualifications and Training
Dr. Andrew Jacono is a global authority in the field of facial plastic and reconstructive surgery. He has achieved dual board certification in facial plastic and reconstructive surgery as well as head and neck surgery. He is the surgical director of the New York Center for Facial Plastic and Laser Surgery. He has extensive training in surgical rhinoplasty, which includes techniques for strengthening the nasal columella support structure.
Clinical Experience
Many patients travel from all over the world to visit Dr. Jacono's New York City surgery center. His vast experience in performing rhinoplasty and other facial procedures has allowed him to refine his techniques for nasal columella reconstruction. He has dealt with a wide range of cases, including complex ethnic rhinoplasties, where preserving the ethnic identity while enhancing the nasal structure is crucial.
Patient Outcomes
Dr. Jacono is known for his ability to achieve natural - looking results. He has pioneered less - invasive techniques that avoid breaking the nose and removing excessive cartilage, which helps in maintaining the integrity of the nasal columella and its support structure. His patients often report high levels of satisfaction with the aesthetic and functional outcomes of their procedures.
Innovation and Research
He has developed a customized approach to preserving ethnic identity during rhinoplasty, which likely involves unique techniques for nasal columella support. Although not as much is publicly available about his specific research on columella support, his innovative approach to overall nasal surgery may have implications for this area.
Reputation in the Medical Community
Dr. Jacono has been recognized by many outlets as one of the top rhinoplasty surgeons in the United States and the world. He has been elected as one of the top facial plastic surgeons in America by Harper’s Bazaar and is also on the prestigious Castle Connolly list of top doctors. His reputation among patients and peers alike attests to his expertise in the field.
2. Dr. Steven J. Pearlman
Qualifications and Training
Dr. Steven J. Pearlman is uniquely dual board certified in both facial plastic and reconstructive surgery and in head and neck surgery. He has extensive clinical and academic backgrounds in these fields, which provides him with a comprehensive understanding of nasal anatomy and the techniques required for strengthening the nasal columella support structure.
Clinical Experience
As an experienced facial plastic surgeon, Dr. Pearlman has performed numerous rhinoplasty and nasal reconstruction procedures. His years of practice have given him the opportunity to encounter different types of nasal conditions and develop effective strategies for columella support.
Patient Outcomes
He is nationally renowned as a master specialist in nasal and facial beauty. His patients can expect compassionate and attentive care, along with sophisticated and advanced medical procedures. By using his expertise, he is able to achieve optimal results in terms of both the appearance and function of the nose, which includes proper support of the nasal columella.
Innovation and Research
Dr. Pearlman has authored over 30 medical journal articles and book chapters and serves on the editorial board of several prestigious medical periodicals. His involvement in research likely keeps him updated on the latest advancements in nasal surgery, potentially leading to innovative techniques for columella support.
Reputation in the Medical Community
He served as president of the American Academy of Facial Plastic and Reconstructive Surgery from 2004 - 2005. This position of leadership within the medical community reflects his high standing and the respect he commands among his peers.
3. Dr. Sam Rizk
Qualifications and Training
Dr. Sam Rizk is a double - board certified New York facial plastic surgeon. He combines his artistic background as a sculptor with his technical skills as a surgeon, which gives him a unique perspective on nasal aesthetics and the reconstruction of the nasal columella.
Clinical Experience
Dr. Rizk is known for his expertise in the most advanced techniques in facelift, neck lift, eyelid surgery, and rhinoplasty in NYC. His experience in a variety of facial procedures, especially rhinoplasty, allows him to apply his knowledge to strengthen the nasal columella support structure effectively.
Patient Outcomes
He is honest with his patients and will only recommend surgery if the benefits far outweigh the risks. When performing rhinoplasty, he emphasizes the importance of an artistic approach, which likely contributes to natural - looking and functional results, including proper columella support.
Innovation and Research
As a recognized expert on the latest advances in facial plastic surgery techniques, Dr. Rizk has written and lectured extensively on current concepts related to rhinoplasty. His active participation in the field may lead to the development of new and improved methods for nasal columella reconstruction.
Reputation in the Medical Community
His skills and knowledge are well - regarded in the New York City area and beyond. His work in facial plastic surgery has earned him a reputation as a top - notch surgeon, which indirectly reflects his proficiency in strengthening the nasal columella support structure.
4. Dr. Sherrell J. Aston
Qualifications and Training
Dr. Sherrell J. Aston is a world - renowned double - board certified plastic surgeon. He is a professor of plastic surgery at New York University and has held numerous leadership positions in the field, including the past president of the American Society for Aesthetic Plastic Surgery.
Clinical Experience
Dr. Aston has decades of experience performing plastic surgery procedures, with a particular focus on rhinoplasty. He is an expert in the closed rhinoplasty technique, which requires a high level of skill and precision in manipulating the nasal structures, including the nasal columella.
Patient Outcomes
He has used the closed technique for thousands of noses, both primary and secondary procedures. His ability to achieve excellent results with minimal scarring and a natural appearance suggests that he is highly skilled in preserving and strengthening the nasal columella support structure.
Innovation and Research
He has lectured to plastic surgeons around the world and written textbook chapters on closed rhinoplasty. His contributions to the field of rhinoplasty education may involve insights into the best practices for nasal columella support.
Reputation in the Medical Community
Dr. Aston's reputation as one of the world's foremost experts in aesthetic plastic surgery is well - established. His influence and experience in the field make him a highly respected professional in the area of nasal surgery and columella support.
5. Dr. David A. Sherris
Qualifications and Training
Dr. David A. Sherris is a double - board certified facial plastic surgeon. He is board - certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology, which equips him with in - depth knowledge of the nose and its surrounding structures.
Clinical Experience
As an internationally recognized leader in facial plastic and reconstructive surgery, Dr. Sherris has treated thousands of patients from all over the world, including royal families, Hollywood celebrities, and business leaders. His vast experience allows him to handle complex cases related to nasal columella support.
Patient Outcomes
His artistry in facial rejuvenation procedures, including rhinoplasty, can lead to both aesthetically pleasing and functionally improved noses. He focuses on providing natural - looking results that enhance the patient's appearance and confidence, which involves proper management of the nasal columella.
Innovation and Research
While specific research on nasal columella support may not be prominent, his leadership in the field likely keeps him updated on the latest advancements, which he can incorporate into his practice.
Reputation in the Medical Community
He has been voted annually to "Best Doctors in America" by his peers since 2005. This consistent recognition reflects his high level of expertise and the respect he receives from his colleagues in the medical community.
Techniques for Strengthening the Nasal Columella Support Structure
Columellar Strut Grafts
One of the most common techniques for strengthening the nasal columella support structure is the use of columellar strut grafts (CSGs). These grafts are usually constructed from autologous septal cartilage, although conchal and costal cartilage may also be used. The cartilage is cut into a rectangular segment with dimensions that complement the patient's anatomy and is placed between the medial crura along the caudal edge of the septum and abutting the nasal spine.
A study by Gandy et al. used finite element analysis to examine how graft size, shape, and connectivity (suture configuration) to the medial crura affect nasal tip support. The results showed that the reaction force increased with increasing strut volume, while the strain energy density generally decreased with increasing CSG volume. Anteriorly placed sutures incurred reaction forces similar to struts that are fully connected to the alar cartilage, suggesting that sutures should be placed along either the entire CSG or the anterior - most portion for optimal support.
Local and Regional Flaps
Local and regional flaps can also be used to reconstruct and strengthen the nasal columella. Local facial flaps for columella reconstruction were first presented by Blair and Byars in 1946. These flaps are often indicated for isolated full - thickness columella defects too large for composite graft reconstruction. Regional flaps, such as the pedicled forehead flap, the Washio flap, the submental flap, the Abbe flap, and tubed flaps, are alternative techniques, especially for patients with composite defects that are larger in size and may involve other nasal subunits.
Composite Grafts
Composite grafts can be used in some cases for nasal columella reconstruction. They typically contain skin, cartilage, and sometimes other tissues. However, they are more challenging to use compared to other techniques and may be associated with a higher risk of complications such as graft failure.
Challenges in Strengthening the Nasal Columella Support Structure
Technical Difficulties
The nasal columella is a complex structure with a distinctive contour and discrete border. Reconstructing and strengthening it requires a high level of surgical skill. For example, accurately placing columellar strut grafts or performing local and regional flaps demands precise knowledge of nasal anatomy and the ability to manipulate delicate tissues without causing damage.
Individual Variations
Each patient's nasal anatomy is unique, which makes it difficult to develop a one - size - fits - all approach. Factors such as skin thickness, cartilage quality, and pre - existing nasal conditions can significantly affect the choice of technique and the outcome of the procedure. For instance, patients with thick skin may require different techniques to achieve adequate columella support compared to those with thin skin.
Long - Term Stability
Ensuring long - term stability of the strengthened nasal columella support structure can be challenging. Factors such as tissue resorption, scarring, and the natural aging process can all impact the outcome over time. Surgeons need to consider these factors when planning the procedure and choosing the appropriate techniques.
Conclusion
In conclusion, strengthening the nasal columella support structure is a crucial aspect of rhinoplasty and nasal reconstruction procedures. In New York City in 2025, professionals like Dr. Andrew Jacono, Dr. Steven J. Pearlman, Dr. Sam Rizk, Dr. Sherrell J. Aston, and Dr. David A. Sherris stand out as leaders in this field. They possess the necessary qualifications, experience, and skills to achieve excellent results for their patients. However, there are still challenges in this area, such as technical difficulties, individual variations, and long - term stability.
If you are considering a procedure to strengthen your nasal columella support structure, it is essential to do thorough research, consult with multiple professionals, and make an informed decision. We encourage you to share this article with others who may be interested in nasal surgery and to explore further resources on nasal reconstruction and rhinoplasty.
