Overview of Nasal Reconstruction in New York City
Nasal reconstruction is a complex and crucial surgical procedure that aims to restore both the form and function of the nose. In New York City, a hub of medical excellence, several hospitals and clinics offer top - notch nasal reconstruction services, including those related to nasal silicone prosthesis repair. This article will introduce you to the top 5 institutions in the city that are renowned for their expertise in this field.
1. City Facial Plastics
Surgeon Expertise
Dr. Gary Linkov at City Facial Plastics is a highly respected reconstructive and facial plastic surgeon. He has spent years helping patients with facial trauma, especially those related to the nose, recover both the function and form of their nasal features. Dr. Linkov is the chief of otolaryngology and facial plastic surgery for the veterans hospital in Brooklyn, where he operates on complex nasal deformities in veterans. This extensive experience gives him an edge in dealing with a wide range of nasal problems, from simple to highly complex cases.
Techniques and Approach
City Facial Plastics in midtown, Manhattan, uses advanced techniques and cutting - edge medical technology. When it comes to nasal reconstruction, the following principles are employed:
- Replace like with like: This means using the same type of tissue to replace lost tissue. For example, if possible, adjacent skin is used to replace skin on the tip of the nose to match color and thickness.
- Aesthetic units: The nose is divided into subunits. If 50% or more of a subunit is affected, the remainder of the subunit is removed, and the entire subunit is replaced to ensure a balanced and aesthetically pleasing result.
- Reconstructive ladder: There is a step - by - step process for nasal septal reconstruction. It starts with simple solutions like letting the area heal on its own (secondary intention) and progresses to more advanced flap procedures.
Treatment Options
The hospital offers a variety of treatment options for nasal reconstruction, depending on the patient's condition:
| Treatment Option | Description |
|---|---|
| Secondary intention healing | The wound closes gradually by itself, which is a simple but potentially prolonged process. |
| Primary intention | Suture closure, suitable for smaller defects on the nose where the surrounding tissue will not distort. |
| Skin graft | Skin is removed from another area, such as the back of the ear, and placed over the nose defect. However, it can result in depression and discoloration. |
| Local flap | Tissue adjacent to the nasal wound is rearranged, advanced, or rotated to fill the defect. Incisions are placed to camouflage the repair. |
| Regional flap | Tissue from areas not immediately next to the nasal defect, like the cheek or forehead, is recruited for closure. This may require multiple procedures. |
| Cartilage/bone graft | Used to provide added support if cartilage or bone is missing. Ear cartilage, rib cartilage, or septal cartilage can be applied. |
| Alloplastic material | For large nasal defects with significant loss of structural support, various foreign materials may be used as a scaffold. |
Recovery and Risks
The recovery after nasal reconstruction at City Facial Plastics depends on the type of reconstruction. Swelling, bruising, light bleeding, and pain can be expected in the first 1 - 2 weeks. Patients should apply antibiotic ointment to the incisions for at least the first week. Risks associated with the surgery include unfavorable cosmetic outcome, pain, bleeding, infection, poor scarring, nasal breathing difficulty, nasal valve collapse, asymmetry, and prolonged healing.
2. Dr. Casian Monaco's Clinic
Approach to Nasal Reconstruction
Dr. Casian Monaco's clinic in New York City's Upper East Side specializes in reconstructive surgery for nasal trauma. Their approach is centered around precision and care, ensuring that patients not only regain the aesthetic appeal of their nose but also its essential functions.
Key Strategies
The clinic focuses on several key strategies during nasal reconstruction:
- Restoring nasal symmetry: Aligning the nose with the rest of the facial features to create a balanced appearance.
- Correcting breathing issues: Addressing internal nasal structures to improve airflow, which is crucial for the overall well - being of the patient.
- Revising previous surgeries: Enhancing the outcomes of earlier nasal procedures, which may have not achieved the desired results.
- Utilizing advanced techniques: Implementing state - of - the - art methods to ensure optimal results.
Customized Treatment
Each case is treated individually, and Dr. Monaco utilizes a range of techniques, such as cartilage grafting, reshaping the nasal bones, and refining the nasal tip and nostrils. The choice of technique is tailored to achieve the best possible functional and aesthetic outcome for each patient.
3. Dr. Joseph Rousso's Office
Surgeon's Expertise
Dr. Joseph Rousso is one of the top facial plastic and reconstructive surgeons in New York City. He has world - wide experience in reconstructive facial surgery, with rhinoplasty and facial reconstruction being his primary specialties. His expertise allows him to achieve functional airway reconstruction of the nasal passages and address aesthetic concerns simultaneously.
Reconstructive Rhinoplasty
Unlike cosmetic rhinoplasty, nasal reconstruction by Dr. Rousso often involves rebuilding tissues that have been lost or damaged, such as skin, bone, and cartilage grafts, depending on the extent of the injury. His goal is to achieve both biological function and aesthetic form with every reconstructive rhinoplasty procedure, giving patients a beautiful, balanced, and functional nose after severe trauma.
4. Dr. Paul R. Khosh's Practice
Comprehensive Nasal Reconstruction
Dr. Paul R. Khosh has extensive experience in nasal reconstruction from various causes, including nasal fractures, nasal defects from trauma or cancer removal, nasal collapse from underlying medical conditions or substance abuse, and nasal deformity from congenital abnormalities.
Treatment for Different Conditions
- Nasal fractures: Most cases can be repaired within 10 days of the accident under local anesthesia during an office visit. Occasionally, delayed treatment in the operating room is required, similar to a rhinoplasty.
- Skin cancer removal: For defects resulting from skin cancer removal on the nose, a variety of techniques such as skin grafts, local skin flaps, forehead flaps, nasolabial flaps, and cartilage grafts may be used, depending on the size and depth of the defect.
- Nose deformity: Conditions like saddle nose deformity, which can be caused by severe nasal fractures, underlying medical conditions, or drug use, are treated with cartilage or bone grafts to support the nose. Congenital problems, such as those in cleft lip patients or due to vascular malformations, are also addressed with specialized techniques.
Case Studies
Dr. Khosh has treated numerous cases successfully. For example, an 84 - year - old woman with a basal cell cancer near the base of the right nostril had a defect repaired using cartilage grafting and a two - staged nasolabial skin flap. Another case involved a 74 - year - old woman with a basal cell skin cancer of the tip of her nose, where cartilage grafts from the ear and a forehead flap were used to restore the projection of the nasal tip and replace missing skin.
5. Mount Sinai's Division of Facial Plastic and Reconstructive Surgery
Expert Surgeons
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 and nasal and facial aesthetics ensures that patients get a nose that not only looks better but also breathes better.
Rhinoplasty Procedures
- Types of rhinoplasty: There are primary rhinoplasty, performed for the first time to address cosmetic concerns and/or nasal breathing, and revision rhinoplasty, which is done to correct issues resulting from prior nose surgeries.
- Techniques: The surgeons perform both closed (endonasal) and open (external) rhinoplasty. 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.
Multidisciplinary Approach
Mount Sinai offers a multidisciplinary approach. For patients with specific concerns related to nasal breathing, allergies, sinus disease, or deformity after cancer treatments, the hospital's experts in the division of rhinology and sinus surgery and the head and neck institute work together to provide comprehensive care. In some cases, combined surgeries are performed.
Choosing the Right Hospital for Nasal Reconstruction
When choosing a hospital for nasal silicone prosthesis repair or nasal reconstruction in New York City, several factors should be considered:
- Surgeon's expertise: Look for surgeons with extensive experience in nasal reconstruction and a good track record of successful cases.
- Techniques and technology: Hospitals that use advanced techniques and the latest medical technology are more likely to provide better results.
- Patient reviews: Reading reviews from previous patients can give you an idea of the quality of care and the patient experience at the hospital.
- Insurance coverage: Check if the hospital accepts your insurance and if the procedure is covered.
Conclusion
In New York City, there are several top - notch hospitals and clinics that offer excellent nasal reconstruction services, including those related to nasal silicone prosthesis repair. City Facial Plastics, Dr. Casian Monaco's Clinic, Dr. Joseph Rousso's Office, Dr. Paul R. Khosh's Practice, and Mount Sinai's Division of Facial Plastic and Reconstructive Surgery each have their own unique strengths and expertise. Whether you are dealing with a nasal injury, a congenital defect, or a complication from a previous surgery, these institutions can provide you with the care and treatment you need.
If you are considering nasal reconstruction, take the time to research these hospitals and schedule a consultation with the surgeons. Discuss your concerns, goals, and treatment options to make an informed decision. Don't let a damaged or disfigured nose affect your confidence and quality of life. Seek the help of these professionals and take the first step towards a better - looking and functional nose.
