Introduction
Nasal repair is a common yet crucial procedure, whether it's for cosmetic reasons, post - injury reconstruction, or to address breathing issues. In New York City, a metropolis known for its world - class medical facilities, there are several hospitals highly recommended by those who have undergone nasal repair. This article will introduce you to some of these outstanding institutions, exploring their services, expertise, and what makes them stand out in the field of nasal repair.
Mount Sinai Hospital
Comprehensive Rhinoplasty Services
Mount Sinai's division of facial plastic and reconstructive surgery is at the forefront of nasal surgery. The nose is a central facial feature with both aesthetic and functional importance, serving as the primary organ of smell and a vital part of the respiratory system. The goal of their rhinoplasty procedures is to create natural, long - lasting results that improve the shape, size, and distinction of the nose. Their facial plastic surgeons are double - board certified in facial plastic and reconstructive surgery and otolaryngology (ear, nose, and throat). This dual certification means they have vast expertise in both nasal function and aesthetics, ensuring that patients not only get a better - looking nose but also improved breathing.
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 their functional and aesthetic goals. Closed rhinoplasty has the advantage of no external scar and a relatively shorter operation time, while open rhinoplasty allows for better visualization of the nasal anatomy and more complex alterations and grafting.
According to the latest statistics from the American Society of Plastic Surgeons, rhinoplasty is one of the most common cosmetic surgeries in the U.S., with over 213,000 people receiving a nose job each year. At Mount Sinai, they can address various concerns through rhinoplasty, such as changing the size and shape of the nose, modifying the bridge, adjusting the size of the nostril openings, balancing facial features, improving nasal breathing for patients with chronic sinus or anatomical problems, and reconstructing previously injured or disfigured noses.
Types of Rhinoplasty Procedures
There are two main types of rhinoplasty procedures offered at Mount Sinai: primary rhinoplasty and revision rhinoplasty. Primary rhinoplasty is performed for the first time to address cosmetic concerns and/or nasal breathing. Revision rhinoplasty, on the other hand, is for patients who have had prior nose surgeries and need to address resulting concerns or deformities.
Multidisciplinary Approach
Patients at Mount Sinai have access to the resources of a large, tertiary hospital. For those with specific concerns related to nasal breathing, nasal allergies, sinus disease, or deformity after cancer treatments, the hospital's team works closely with experts in the division of rhinology and sinus surgery and the head and neck institute. They can even perform combined surgeries when appropriate. This multidisciplinary approach ensures that patients receive comprehensive and specialized care tailored to their specific needs.
Combining Procedures
Some areas of the face are closely related, and combining procedures can often lead to better outcomes. Patients who undergo rhinoplasty for cosmetic improvements may benefit from cheek or chin implants to improve facial balance. Mount Sinai's cosmetic surgeons try to combine procedures whenever possible to reduce recovery time and lower operating costs.
Adolescent Rhinoplasty
Rhinoplasty is also a common procedure among teenagers and youth. However, if the surgery is for cosmetic reasons, younger patients should wait until they stop growing and their nasal bone has reached its adult size. Typically, girls can consider it around age 15 after puberty, while boys may need to wait until 17 or 18 years or older. If the 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 interested in cosmetic treatments at Mount Sinai 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. Before surgery, patients are given instructions regarding medications and how to prepare for recovery. After surgery, they are usually given a short course of antibiotics and mild pain medication. The majority of swelling subsides within the first two weeks, but it may take up to a year for all the swelling to fully fade. Patients can expect to return to work or school within one to two weeks after surgery and are asked to avoid strenuous activities for two weeks.
Cost of Rhinoplasty
Cost is always a concern for patients. Insurance may cover surgery performed to improve breathing, such as for a deviated septum, but it does not cover cosmetic - only surgeries. Mount Sinai provides patients with expected costs prior to any intervention.
City Facial Plastics
Nasal Fracture Repair Expertise
City Facial Plastics, located in Manhattan, NY, offers exceptional nasal fracture repair services. A nasal fracture, commonly known as a “broken nose,” can be caused by various factors such as falls, sports injuries, physical altercations, and motor vehicle accidents. Symptoms of nasal bone fractures include swelling, bruising, pain, change of shape, and nosebleeds. Nasal fractures are not only physically painful but can also have a significant emotional and psychological impact due to the change in appearance. They are quite common, accounting for 40% of all facial traumas.
Relevant Anatomy and Diagnosis
The nose is the most prominent facial feature and is thus particularly prone to injury. It is primarily made of cartilage, with the upper part being bone. The upper paired nasal bones are the typical site of injury during a nasal fracture, and the nasal septum, which separates the right and left sides of the nose and is mostly made of cartilage, may also be fractured. Nasal fractures can be diagnosed by a radiograph image (X - ray or CT scan), but the best way is through a physical examination by pressing on the top of the nose and feeling a “step off,” which corresponds to the site of malposition of the bone. A nasal fracture can also cause a deviated septum, as the initial trauma to the nose may cause the septum to shift independent of the nasal bone.
Treatment Options
Nasal fractures are usually not repaired on the day of injury due to the significant swelling. After several days when the swelling has decreased, a closed reduction nasal fracture surgery can be performed. This should be done within 10 - 14 days of the nasal injury when the bones can still be easily manipulated. For those who do not seek medical attention right away, rhinoplasty may be required for repair at least 6 months after the injury.
Candidate Selection
A nasal fracture alone is not enough to indicate the need for repair. The best candidates for nasal fracture repair in New York City include patients with nasal obstruction as a result of the nasal fracture injury or cosmetic nasal change from the injury. If neither criterion is met, the nose can usually be observed.
Closed Reduction Nasal Fracture Surgery
Closed reduction nasal fracture surgery is indicated for acute nasal bone fractures with functional or cosmetic consequences. In this surgery, no incisions are made on the skin. Instead, surgical instruments are inserted into the nostril after adequate decongestion. The surgeon then manipulates the bones and surrounding nasal structures to restore the fractured nasal bones to their normal position. The repositioned bones are kept in place with internal absorbable packing and/or an external splint along the bridge of the nose.
Pre - surgery Preparation
Patients recommended for closed reduction nasal fracture surgery need to take several steps to prepare. They should avoid certain medications and supplements that may thin the blood, such as NSAIDs (ibuprofen and naproxen), aspirin, warfarin, and vitamin E. They should pick up medications prescribed by the doctor, identify an escort home if sedative medication will be used during surgery, and not eat or drink after midnight the night before the surgery.
Intra - surgery and Recovery
On the day of the procedure, patients meet with an anesthesiologist to review their medical history before receiving anesthesia. Closed reduction nasal fracture surgery usually takes between 30 to 60 minutes. After the surgery, a cast is placed externally on the nose and removed in the office one week later. Internal packing may be placed inside the nose and will dissolve on its own. Bruising and swelling are common and may take 1 - 2 weeks to resolve. In the first week after surgery, patients should keep the head of their bed elevated at least 30 degrees, sneeze with their mouth open, avoid blowing their nose, and avoid heavy lifting.
Risks and Complications
Although closed reduction nasal fracture surgery is typically needed to restore normal function and appearance of the nose, there are some risks and complications. These include bleeding (minor nose bleeding is normal in the first few days, and the nose may be packed to reduce the risk), infection (rare, and antibiotics are usually administered to reduce the risk), saddle nose deformity (which may require rhinoplasty to fix), instability of nasal structures or incomplete repair, and the need for revision surgery.
Contraindications and Alternatives
Some people may not be candidates for closed reduction nasal fracture surgery, such as those with severe kidney, liver, or cardiac disease (unless cleared by a specialist for anesthesia and surgery), poorly controlled diabetes, or an allergy to certain anesthesia medications. Alternatives to closed reduction nasal fracture surgery include no surgery at all (for minor fractures or those with high surgical risks) and open reduction nasal fracture surgery (for those who seek care after the 10 - day period or have delayed seeking medical attention).
LM Medical NYC
Nasal Reconstruction Services
The nose is one of the most commonly injured or disfigured facial features, often due to sports injuries, auto accidents, falls, burns, skin cancer, and other events. At LM Medical NYC, double - board certified facial plastic surgeon Dr. Lesley Rabach offers nasal reconstruction surgery at their clinics in Manhattan. A nose injury or disfigurement can have a dual impact, affecting both breathing function if the nasal passages or sinuses are blocked and the appearance of the face.
Expertise in Trauma Repair
Dr. Lesley is a top facial plastic surgeon specializing in cosmetic nose reshaping and is also board - certified in otolaryngology - head and neck surgery. Her experience in both facial reconstruction for function and plastic surgery for aesthetics is crucial for nose trauma repair. During nasal reconstruction surgery, repairs may be needed to the bone and cartilage structure of the nose to restore proper breathing. Once the functional aspect is corrected, she can reshape the exterior of the nose for a balanced and beautiful appearance that matches the facial features.
Patient Testimonials
Many patients have left positive testimonials about their experiences at LM Medical NYC. They praise the accuracy, professionalism, and patient care of the practice. Dr. Lesley Rabach is commended for her ability to recommend small adjustments that look natural yet give noticeable results. Her warm and caring bedside manner, along with the friendly and efficient office staff, also contribute to the positive patient experience.
New York - Presbyterian Hospital - Columbia and Cornell
Nose and Sinus Disease Care
New York - Presbyterian Hospital - Columbia and Cornell, in collaboration with Weill Cornell Medicine, is committed to providing high - quality nose and sinus disease patient care. Their faculty members are leaders in the field, advancing both non - surgical and surgical treatments for various sinus conditions.
They offer solutions for acute sinusitis, chronic sinusitis, endoscopic closure of cerebrospinal fluid (CSF) leaks, management of sinus tumors, orbital decompression for Graves’ disease, and pituitary tumors using minimally invasive approaches. They also provide diagnosis for deviated nasal septums, allergic rhinitis, environmental allergies, nasal polyps, and epistaxis (nasal bleeding).
Comprehensive Evaluation and Treatment
Physicians at this institution direct comprehensive evaluations and care for patients. This includes endoscopic examination, radiologic evaluation, endoscopic nose and sinus surgery, inclusive treatment with medications and topical therapy, in - office procedures such as balloon sinuplasty and inferior turbinate reduction, and complimentary referrals to allergists and acupuncturists for complete care. The surgeons operate at the New York - Presbyterian Hospital/Weill Cornell Medical Center, which is consistently among the top - rated hospitals in New York City and the U.S., and they utilize the latest surgical tools, including intraoperative image guidance.
NYU Langone Hospitals
Surgical Treatment for Chronic Sinusitis
At NYU Langone, doctors recommend sinus surgery only when over - the - counter or prescription medications and other therapies fail to relieve symptoms of chronic sinusitis. Their surgeons can correct structural problems within the nasal passages and sinuses and remove polyps or other tissue blocking the nasal passages, allowing mucus to drain normally, reducing facial pressure and pain, restoring the sense of smell, and making it easier to breathe.
Endoscopic Sinus Surgery
Endoscopic sinus surgery is the most commonly recommended procedure for chronic sinusitis. It uses a thin endoscope inserted through the nostrils, attached to a miniature camera and light source. High - resolution images of the nasal passages and sinuses are transmitted to a high - definition monitor in the operating room. The surgeon uses CT scan images as a roadmap to guide the surgery. Tiny surgical instruments are used to remove unwanted tissue or polyps, correct a deviated septum, or reduce enlarged turbinates. This procedure takes about two hours and does not require an overnight hospital stay, and there is no swelling or bruising of the face.
Image - Guided Sinus Surgery
Due to the precise location of the sinuses near the eyes and brain, NYU Langone surgeons may suggest image - guided or computer - assisted endoscopic sinus surgery for a safer and more thorough procedure. Before the surgery, data from a sinus CT scan is uploaded to a computer. After the endoscope is in place, the micro - instruments used by the surgeon are connected to the same computer, allowing the surgeon to see the location of the instruments in the sinuses with high accuracy. This procedure also takes about two hours and is performed under general anesthesia.
Balloon Sinuplasty
Balloon sinuplasty allows the surgeon to dilate a blocked sinus, creating open space for normal draining. A thin wire is guided through the nasal passages to the blocked sinus opening, followed by a thin catheter with a small balloon. The balloon is inflated to dilate the sinus opening. This procedure takes about an hour and is performed under general anesthesia. If the sinus blockage is not responsive to balloon sinuplasty or the symptoms are severe, it may be combined with endoscopic or image - guided sinus surgery.
Post - surgery Care
After surgery, NYU Langone doctors schedule several follow - up appointments to monitor the patient's recovery and provide continued support to manage the symptoms of chronic sinusitis effectively.
Conclusion
In conclusion, New York City is home to a variety of hospitals that excel in nasal repair. Mount Sinai Hospital offers comprehensive rhinoplasty services with a multidisciplinary approach, while City Facial Plastics is an expert in nasal fracture repair. LM Medical NYC specializes in nasal reconstruction, New York - Presbyterian Hospital - Columbia and Cornell provides high - quality nose and sinus disease care, and NYU Langone Hospitals offers effective surgical treatments for chronic sinusitis. Each of these institutions has its unique strengths and expertise, ensuring that patients can find the right place for their nasal repair needs.
If you are considering nasal repair, we encourage you to explore these hospitals further. Contact them to schedule consultations, learn more about their treatment options, and speak with the medical staff to make an informed decision about your nasal repair journey. Share this article with others who may benefit from this information, and continue to educate yourself on the latest advancements in nasal repair.
