Introduction
Columella shortening plastic surgery is a specialized area of plastic surgery that aims to enhance the aesthetic appearance of the nose. In New York City, there are several top - level Class - III public hospitals that offer high - quality columella shortening plastic surgery services. These hospitals have experienced plastic surgeons, advanced surgical techniques, and a focus on patient safety and satisfaction. In this article, we will introduce one such prominent hospital in New York City and explore various aspects related to columella shortening plastic surgery.
Columbia University's Plastic Surgery Division
Overview of the Hospital
Columbia University's plastic surgery division is one of New York’s best hospitals and is recognized as one of the world’s top medical centers. It has a wealth of experience in providing both cosmetic and reconstructive plastic surgery procedures. The hospital's mission is to utilize its numerous resources to deliver the highest - quality care to patients in need of plastic surgery, including columella shortening plastic surgery.
The clinical staff of plastic surgeons at Columbia University are highly proficient in multiple areas of specialization. Their areas of expertise range from routine, non - surgical cosmetic procedures to complex reconstructive operations and body contouring surgery after significant weight loss. The division is also at the forefront of clinical and laboratory research in plastic surgery, making it a national and international leader in the field.
Plastic Surgery Programs and Services
Columbia University offers a wide range of plastic surgery programs and services, which can be broadly categorized as follows:
| Program Category | Description |
|---|---|
| Cosmetic Care | The cosmetic care program provides surgical and non - surgical options to improve cosmetic health. It includes procedures such as ear and eyelid lifts, breast augmentation, tummy tucks, and many others relevant to facial and body aesthetics. For columella shortening plastic surgery, it falls within the realm of nasal cosmetic surgery under this program. |
| Reconstructive Care | Columbia's plastic surgeons are world - leaders in reconstructive care. They deal with issues like breast reconstruction after breast cancer, skin lesion excision, and reconstructive surgery for the nose and ears. If columella shortening is required due to a reconstructive need, such as after an injury or a congenital defect, this program would be applicable. |
| Cleft Palate/Cleft Lip Care | Cleft lip and cleft palate are common congenital conditions. The hospital's craniofacial surgery program provides specialized care for these children. Sometimes, children with cleft lip and palate may also require columella - related surgical procedures, and this program can offer comprehensive treatment. |
| Orthoplastic Surgery Care | This program brings together leading experts in orthopedic and reconstructive plastic surgery. It offers thoughtful, personalized treatment options for complex surgeries, with lower wound complication rates and higher patient satisfaction in recovery. |
| Breast Reconstructive Care | The breast cancer reconstructive surgery program at Columbia is dedicated to helping individuals who have undergone breast cancer surgery reclaim their physical and emotional well - being. It involves collaboration between cancer experts and reconstructive plastic surgeons. |
Available Cosmetic and Reconstructive Procedures
Cosmetic Procedures
- Face: Brow lift, chin surgery, face lift (rhytidectomy), Botox injection, injectable fillers, cosmetic nose surgery (rhinoplasty), cosmetic ear surgery (otoplasty), cosmetic eyelid surgery (blepharoplasty), neck lift. Among these, rhinoplasty is directly related to columella shortening plastic surgery as it can address the shape and length of the columella.
- Breast: Breast augmentation, breast reduction (mammoplasty) & gynecomastia (for men), breast lift (mastopexy).
- Body: Liposuction, arm lift surgery (brachioplasty), body contouring after weight loss (body lift & thigh lift), tummy tuck (abdominoplasty).
- Other: Scar revision surgery.
Reconstructive Procedures
- Abdominal wall reconstruction
- Breast reconstruction after mastectomy
- Cleft lip and palate repair
- Craniofacial surgery
- Extremity reconstruction
- Microsurgery
- Otoplasty reconstruction
- Rhinoplasty (for reconstructive purposes)
- Skin lesion excision
- Skin – Moh's procedure
The Plastic Surgery Team
Columbia's division of plastic & reconstructive surgery has a team of board - certified surgeons who are highly skilled in different aspects of plastic surgery. Here are some of the key surgeons:
- Christine Rohde, MD: She is the chief of the division of plastic surgery. A highly skilled clinician, researcher, and teacher, Dr. Rohde is trained in the diagnosis and treatment of the full range of plastic reconstructive and aesthetic surgery. She specializes in microsurgery, abdominal wall reconstruction, body contouring, cosmetic surgery, and breast, trauma, and cancer reconstruction. She is also the chief of microvascular services for the plastic surgery division and has numerous publications and presentations in the field.
- Jeffrey A. Ascherman, MD: An experienced plastic and reconstructive surgeon, Dr. Ascherman has published over 75 scientific articles and chapters. He has been included multiple times in Castle Connolly’s list of America’s top doctors and in New York magazine’s annual list of best doctors. He has also participated in humanitarian surgical missions in China and South America.
- Jarrod T. Bogue, MD: Dr. Bogue completed his plastic surgery training at NewYork - Presbyterian's integrated residency program, followed by a fellowship in microsurgery at Memorial Sloan Kettering. He specializes in microsurgery, orthoplastic surgery, abdominal wall reconstruction, as well as cancer and trauma reconstruction.
- Thomas A. Imahiyerobo, MD: As the section chief of pediatric plastic and reconstructive surgery and director of cleft and craniofacial surgery, Dr. Imahiyerobo is a national leader in the treatment of cleft lip, cleft palate, craniosynostosis, frontal facial advancement, and orthognathic (jaw) surgery. He also specializes in the care of adult cosmetic and reconstructive surgery of the head and neck. He is involved in outcomes research for cleft lip and palate surgery and the effects of craniosynostosis on pediatric cognitive development.
- Catherine L. Ly, MD: A highly skilled plastic and reconstructive surgeon, Dr. Ly's clinical and research interests are in post - traumatic and oncologic reconstruction, with a focus on microsurgical techniques, surgical education, and health disparities. She is committed to providing compassionate care and optimizing patient outcomes.
- Naik Hoba Munabi, MD: Dr. Munabi has extensive training in the full breadth of plastic and reconstructive surgery. She has a particular interest in cleft lip, cleft palate, craniosynostosis, hypertelorism, frontal facial advancement, orthognathic surgery, rhinoplasty, and Medpor ear reconstruction for microtia. She also specializes in adult aesthetic and reconstructive surgery of the head and neck.
- June K. Wu, MD: A board - certified plastic surgeon, Dr. Wu specializes in pediatric reconstructive surgery and pediatric vascular anomalies. She trained at Boston Children’s Hospital before joining the team at Columbia.
Understanding Columella Shortening Plastic Surgery
Anatomical Considerations
The columella is the vertical strip of tissue that separates the nostrils at the base of the nose. In columella shortening plastic surgery, the aim is to adjust the length and appearance of the columella to achieve a more balanced and aesthetically pleasing nasal shape. Different ethnic groups may have different nasal anatomical characteristics that need to be considered during the surgery. For example, Asians generally have underdeveloped nasal cartilages and a thicker fibrofatty layer including the superficial musculoaponeurotic system (SMAS) around the nose, which can affect the surgical approach.
Cartilage harvesting is an important aspect of rhinoplasty, including columella - related surgeries. Ear cartilage, septal cartilage, and rib cartilage can be used. Ear cartilage has high elasticity and sufficient thickness, and retains a natural curve, making it suitable for areas requiring curvature. However, nasal septal cartilage, which is often the donor choice for Westerners, may not be sufficient in size and quality for Asians due to underdevelopment. Rib cartilage can provide a large volume but may leave a scar in the chest and has the risk of warping.
Surgical Approaches
Open Rhinoplasty vs. Closed Rhinoplasty
Asians, in particular, often have relatively small nostrils and underdeveloped cartilages. Closed rhinoplasty has the advantage of less disruption of columellar support and better preservation of blood and lymphatic circulation. However, it may be difficult to carry out all the necessary maneuvers for support and tip definition in this approach. Open rhinoplasty, on the other hand, facilitates better control of the nasal SMAS. Since most Asian noses have underdeveloped cartilage and a thick fibrofatty layer in the tip and supratip areas, open rhinoplasty allows for the harvesting of the pitanguy ligament and the nasal SMAS during the skeletonization of the nasal cartilage and bone. The harvested nasal SMAS can then be used to control the volume and line of the nose.
Techniques for Columella Shortening
Techniques for columella shortening may involve the use of sutures to reshape the cartilage frame. The lateral crural steal technique is one such method, where the lateral crus is repositioned to the dome to increase the middle crural length. A columella strut graft is also necessary to create and maintain tip projection. In the case of ear cartilage, a long shield graft can be placed in front of the medial crus to increase the caudal projection of the tip and create a stable structure.
Complications and Management
One of the common complications in rhinoplasty, including columella shortening plastic surgery, is capsular contracture when using alloplastic materials such as silicone implants. Secondary capsular contracture can lead to various deformities, which can be classified into different grades. A natural appearance, as if no implant has been inserted, can be classified as grade 1. An unnatural lateral margin of an implant can be classified as grade 2, a clearly identified implant deviation as grade 3, and a short nose deformation as grade 4. It is important for surgeons to clinically classify these deformations and establish appropriate treatment algorithms.
To manage complications, it may be necessary to remove or release the fibrofatty layer of SMAS along with the capsular contracture to gain a sufficient soft tissue volume, which provides further stability to the cartilage framework.
Residency and Training Programs at Columbia
Columbia University's plastic surgery division also plays an important role in education and training. The combined divisions of plastic surgery at New York - Presbyterian Hospital's Columbia University Irving Medical Center and Weill Cornell Medical Center offer a fully ACGME - accredited 6 - year integrated plastic surgery residency program in the heart of New York City.
Clinical Curriculum
The first two years of the 6 - year integrated program consist of prerequisite surgical training in a variety of general - and plastic surgery - related specialties, including breast surgery, head & neck surgery, neurosurgery, burn care, vascular surgery, transplant, pediatric surgery, orthopedic surgery (hand), dermatology, surgical ICU, emergency medicine, anesthesiology, surgical oncology, and oral maxillofacial surgery. The final four years consist of full - time plastic surgery training throughout all the affiliated hospitals, including Weill Cornell Medical Center, Columbia University Irving Medical Center, Harlem Hospital, Memorial Sloan - Kettering Hospital, and the Hospital for Special Surgery.
Research Requirements
As part of a world - class academic institution, residents in the Weill Cornell and Columbia University combined divisions of plastic surgery are required to pursue independent clinical or basic science research during their time in the program. On average, residents produce at least one academic manuscript a year, with most residents graduating with multiple publications, presentations, and abstracts in prominent academic journals. They are also encouraged and supported to attend regional and national meetings.
Benefits of the Residency Program
Residents in this program have the unique advantage of training at two world - class Ivy League medical institutions. They are exposed to a diverse range of clinical disorders managed by plastic surgeons, from complex tertiary care reconstructions to a resident - run aesthetic surgery clinic. They also get exposure to burn care, trauma management, and cancer treatment at multiple institutions. The program is located in the heart of New York City, providing residents with access to hospital - subsidized housing in the famed upper east side, along with a rich cultural and lifestyle experience.
Conclusion
In New York City, Columbia University's plastic surgery division stands out as a top - level option for columella shortening plastic surgery. With its experienced surgical team, comprehensive plastic surgery programs, advanced research facilities, and high - quality education and training programs, it offers patients the assurance of excellent care. The understanding of different anatomical characteristics, the availability of various surgical approaches, and the ability to manage complications make it a reliable choice for those seeking columella shortening plastic surgery.
If you are considering columella shortening plastic surgery or want to learn more about the services offered at Columbia University, we encourage you to reach out. You can call (212) 305 - 3103 or request an appointment online. Share this article with others who may be interested in plastic surgery, and continue exploring the related topics to make an informed decision about your cosmetic or reconstructive needs.
