Introduction
The nasal bridge plays a crucial role in the overall appearance of the face. Whether it's a wide bridge, a flat or depressed bridge, a dorsal bump, or a saddle nose deformity, there are various concerns that individuals in New York City may have regarding their nasal bridge. Fortunately, there are several top - notch hospitals and clinics in the city that offer high - quality nasal bridge correction procedures. In this article, we will explore the top five institutions for nasal bridge correction in New York City, along with the services they provide and the expertise of their surgeons.
1. Cangello Plastic Surgery
Surgeon and Specialties
Dr. David Cangello is a board - certified plastic surgeon in New York City. He is widely recognized as a leader in rhinoplasty and a pioneer of preservation rhinoplasty. Nasal bridge surgery is fundamental to rhinoplasty, and Dr. Cangello is experienced in a range of techniques to successfully treat a variety of nasal bridge issues.
Preservation Rhinoplasty
Dr. Cangello is among an elite few surgeons to offer preservation rhinoplasty, and is one of the first rhinoplasty surgeons to offer this technique in the U.S. This modern approach to nose reshaping preserves as much of the original nasal structure as possible. By retaining the existing tissue, cartilage, and bone, it allows for a natural - looking result, improved nasal function, and a lower risk of complications. Preservation techniques are well - suited for nasal bridge concerns, such as removal of humps, general bridge reshaping, and correction of minor asymmetries.
Comparison with Traditional Surgery
Preservation rhinoplasty offers several key benefits over traditional nasal bridge surgical techniques. For up to 80% of patients seeking nasal bridge surgery, Dr. Cangello employs this approach. One of the significant differences is that the dorsum is completely preserved, eliminating the need for reconstruction and cartilage grafts. Instead of shaving down the dorsum, bone and cartilage removal occurs underneath the nose bridge, and the intact dorsum can be easily repositioned to lower the height of the nasal bridge. This eliminates the possibility of dorsum irregularities and reduces the need for revision rhinoplasty procedures. Another difference is in the dissection plane. In a preservation procedure, the perichondrium and the periosteum are left intact. By dissecting below these layers, the veins, arteries, and lymphatics are preserved, almost eliminating bruising and swelling and minimizing their duration. Finally, the tip plasty approach in a preservation procedure emphasizes a more natural look, avoiding problems with nose tip proportion.
Specific Nasal Bridge Surgeries
- Narrowing the Nasal Bridge: When planning to narrow an overly wide nose, several factors need to be considered. These include the width of the nasal base (a wide or flared alar base may require reduction if it extends beyond the inner canthus of each eye), the natural shape and desired aesthetic of the nasal tip, the proportions of the nose in relation to ethnicity and facial features, and the thickness and elasticity of the skin.
- Correcting a Dorsal Bump: Removing a hump on the bridge of the nose may seem simple, but it requires a comprehensive rhinoplasty plan. In addition to hump removal, the surgeon may need to perform osteotomies to bring the width of the nose in proportion to the new bridge height, consider the integrity of the middle vault of the nose to determine if spreader grafts are necessary, and revise the position and shape of the nose tip to harmonize with the slope of the nose.
- Correcting a Saddle Nose Deformity: A saddle nose deformity is characterized by a concave nasal bridge. It can be caused by a traumatic injury, a failed rhinoplasty, cocaine abuse, certain medical conditions, or be congenital. Surgical correction involves restoration or augmentation of the nasal bridge. In mild cases, a graft of septal cartilage may be sufficient, while more severe cases may require more extensive grafting, such as costal cartilage grafting or a synthetic biocompatible grafting material.
- Improving Breathing Function: For Dr. Cangello, form and function are synchronous. Many patients who undergo nasal bridge surgery experience a passive improvement in nasal function due to the correction of underlying nasal obstruction. In cases where the nasal bridge deviation is due to septal deviation, septoplasty, which can improve nasal airflow, is incorporated into the initial surgical plan.
2. Mount Sinai - New York
Department and Surgeons
At Mount Sinai’s division of facial plastic and reconstructive surgery, the goal with each patient’s 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 will not only look better but also breathe better.
Rhinoplasty Procedures
Commonly known as a “nose job,” rhinoplasty is one of the most common cosmetic surgeries performed in the U.S. At Mount Sinai, rhinoplasty changes the shape of the nose by modifying the bone and cartilage of the nasal framework. After accessing the framework through carefully concealed incisions, the bone of the upper portion of the nose is sculpted and smoothed, and the cartilage in the lower portion is reshaped to bring all dimensions of the nose into harmony. The nasal septum is straightened and reshaped to improve breathing, and any necessary grafts are used to support and contour the final result.
Types of Rhinoplasty
| Type | Description |
|---|---|
| Primary Rhinoplasty | Performed for the first time to address cosmetic concerns and/or nasal breathing. |
| Revision Rhinoplasty | Performed to address concerns or deformities resulting from prior nose surgeries. |
| Closed (Endonasal) Rhinoplasty | All incisions are made inside the nose. Advantages include the lack of an external scar and a relatively shorter operation duration. |
| Open (External) Rhinoplasty | A small incision is added at the base of the nose to increase the surgical field of vision. This approach allows for better visualization of the nasal anatomy and more complex alterations and grafting to be performed. |
Multidisciplinary Approach
Patients at Mount Sinai have the resources of a large, tertiary hospital at their disposal. For patients with specific concerns related to 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.
Combining Procedures
Some areas of the face are intimately related and often need to be addressed together to achieve the best outcomes. Patients who have rhinoplasty for cosmetic improvements may benefit from cheek or chin implants to improve facial balance. Whenever possible, the cosmetic surgeons at Mount Sinai combine procedures to reduce recovery time and lower operating costs.
Adolescent Rhinoplasty
If a nose job is for cosmetic reasons, younger patients should wait until they stop growing and their nasal bone has reached its adult size. Typically, girls should wait until around age 15 after puberty, while boys may need to wait until they are 17 or 18 years or older. However, 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.
3. Dr. Khosh's Clinic
Services for Nasal Bridge Concerns
Dr. Maurice M. Khosh, a double - board certified facial plastic surgeon, has a successful practice in Manhattan, NY. He is a pioneer in saddle nose deformity correction and repair. For patients with a wide nasal bridge, he offers both non - surgical and surgical solutions.
Non - Surgical Solution for Wide Bridge
Injection of facial fillers such as Restylane or Juvederm can be used to elevate the height of the nose, creating a perceived narrowing of the bridge. This is a non - invasive option for those who want to see a temporary improvement without undergoing surgery.
Surgical Solution for Wide Bridge
A closed rhinoplasty procedure, accessing the nasal bones through the inside of the nostrils, can be used to narrow a wide - bridged nose. The nasal bones are brought closer together in a technique called osteotomy.
Saddle Nose Repair
When the bridge of the nose collapses, creating a saddle - nose deformity, it can impact both appearance and function. Dr. Khosh specializes in saddle nose repair, restoring the structure and aesthetics of the nose. Saddle nose deformities can be caused by trauma, infection, autoimmune diseases, intranasal drug use, or surgical complications. For major saddle nose deformities or to permanently repair the nose, surgical cartilage grafting is required. Dr. Khosh has extensive experience in completing the needed cartilage harvesting and grafting to restore the support and shape of the nose, while also ensuring aesthetic balance with the facial features.
4. Dr. Casian Monaco's Clinic
Expertise in Flat or Depressed Bridge Correction
At the office of Dr. Casian Monaco in New York City, specializing in flat or depressed bridge correction surgery is a key area of expertise. This specific form of rhinoplasty addresses the unique aesthetic and functional concerns associated with a flat or depressed nasal bridge, which is common in many ethnicities and sometimes a result of injury or congenital conditions.
Understanding the Procedure
The nasal bridge plays a pivotal role in the overall appearance and profile of the face. A flat or depressed bridge can disrupt this balance, often leading to a lack of definition and character in facial features. Dr. Monaco's approach to correcting this involves sculpting the nasal structure, enhancing not only the bridge but ensuring that the changes harmoniously blend with the individual’s facial anatomy.
Tailored Techniques
- Grafting: Using the patient’s own tissue or synthetic materials to build up the nasal bridge.
- Osteotomy: Careful adjustment of the nasal bones to create a more defined bridge.
- Cartilage Sculpting: Reshaping and repositioning the cartilage for a more pronounced and natural - looking bridge.
Impact of the Procedure
Correcting a flat or depressed nasal bridge goes beyond physical appearance. It often enhances breathing functionality, boosts self - confidence, and aligns a person’s external appearance with self - identity. Dr. Monaco's patients, from diverse backgrounds across New York City and beyond, frequently express how this surgery has positively impacted their lives.
5. City Facial Plastics
Surgeon's Qualifications
Double board - certified and Ivy League - educated facial plastic surgeon Dr. Gary Linkov takes a sophisticated approach to rhinoplasty. As one of the best rhinoplasty surgeons in New York City, he considers ethnic characteristics, cosmetic, and functional imperfections when meticulously planning the process and outcome. He has performed more rhinoplasty procedures than the majority of facial plastic surgeons in New York and is an adjunct assistant professor at New York University.
Rhinoplasty Services
Rhinoplasty at City Facial Plastics involves making changes to the skeleton of the nose to improve breathing and/or appearance. Dr. Linkov recommends both functional and aesthetic rhinoplasties at the same time, which can address several medical conditions, such as breathing or sinus issues, a deviated septum, imperfections from a skin cancer cure, or breaks that weren’t set properly.
Types of Rhinoplasty
| Type | Description |
|---|---|
| Closed Rhinoplasty | An endonasal approach with no visible incisions. It has limitations in terms of visibility but may allow the surgeon to better judge the outcome during the surgery as the nasal skin remains in place. It may cause nasal tip swelling if the tip is manipulated. |
| Open Rhinoplasty | Uses an external approach with a small incision at the mid - columella. It allows for a more complex reconstruction and provides greater visibility for the surgeon but may leave more swelling after surgery and has a rare risk of poor scarring at the external incision site. |
Patient Evaluation and Preparation
Before rhinoplasty, Dr. Linkov schedules two initial consultations. During the first consultation, he covers the patient's health history, medications, current health disorders, and lifestyle habits. During the second appointment, the patient outlines their goals for surgery. Dr. Linkov conducts an in - depth facial evaluation, takes pictures of the nose from eight different angles with digital imaging computer software, and shows a 3D simulation of the post - surgery nose. The patient and the surgeon then decide on the approach (open or closed rhinoplasty).
Procedure and Recovery
The rhinoplasty procedure is performed under twilight or general anesthesia and takes two to four hours. The major steps include exposing the underlying structures, sourcing cartilage as a building material (usually from the patient's own nose, ear, or rib), grafting, manipulating the bones, and closing up. After surgery, there is a short - term healing phase with common anticipated conditions such as bruising, redness, swelling, bleeding, nasal obstruction, and some pain. Precautions are needed during this phase to ensure the best result. The long - term healing phase occurs in the weeks to months following surgery, and the final results are usually seen about one year after the surgery.
Conclusion
In New York City, there are several excellent hospitals and clinics for nasal bridge correction. Whether you are dealing with a wide bridge, a flat or depressed bridge, a dorsal bump, or a saddle nose deformity, the top five institutions mentioned - Cangello Plastic Surgery, Mount Sinai - New York, Dr. Khosh's Clinic, Dr. Casian Monaco's Clinic, and City Facial Plastics - offer a range of solutions tailored to your specific needs. Each of these places has experienced and qualified surgeons who use advanced techniques to achieve natural - looking and functional results. If you are considering nasal bridge correction, it is advisable to consult with one of these top providers to discuss your goals and explore the best treatment options for you.
Ready to take the next step towards enhancing your appearance and confidence? Contact one of these top - rated New York City nasal bridge correction providers today to schedule a consultation. Don't let nasal bridge concerns hold you back any longer!
