Archive for the ‘Rhinoplasty’ Category
Facial cosmetic surgery is a very personal and monumental decision. Universally, all patients want the best outcomes. In today’s corporatized America, with heavily influential marketing spin, pharmaceutical companies, medical device companies, and even practitioners promote a less is more mentality to push products and services that often over promise and under deliver on the results. In no way can skin creams, injectables, or lasers deliver the types of results once can achieve with surgery. In a similar manner, minimally invasive sounding surgeries are in no way a substitute for time tested peer reviewed procedures that provide quality long lasting results.
Unfortunately not every person will achieve acceptable results with Botox or injectable fillers such as Juvederm, Restylane, and Radiesse. These products have their place in facial aesthetic practices, in properly selected patients, but in general should be viewed as temporary treatments with less impressive results when compared to surgery. Their primary advantage is that they have minimal social while providing a benefit. Botox is being used more and more as a preventative cosmetic medicine that delays wrinkle formation. Fillers camouflage initial signs of aging, but ultimately putting too much filler in a face, the liquid facelift, can alter ones appearance creating an artificial overinflated appearance. Using filler to augment facial structures can be useful to patients wanting to get a general idea of the appearance prior to permanent surgical procedures such as lip and cheek enhancements procedures. Creams reverse the signs of photo aging and contribute to collagen formation and production but are limited in their effectiveness. Lasers are an excellent option to delay the signs of aging and treat sun induced skin photoaging, but in no way can they tighten skin like facial cosmetic surgeries such as a facelift.
Surgical procedures are the best option for impressive endurable results. Rhinoplasty can dramatically affect ones facial appearance in a way that almost no other cosmetic surgery can. The nose can cause undue and unnecessary attention drawing attention away from other attractive facial features. Aging face surgery has many layers of effectiveness based on the surgical techniques used and how they are applied. In general, minimally invasive techniques can produce an artificial appearance and or short-term results. When considering aging face surgery most sophisticated patients are looking for surgeries that will last as long as possible with the most dramatic natural appearing results. There are no shortcuts to achieving optimal results and when applied, shortcut techniques frequently under deliver on the surgical results end.
Becoming an informed patient who understands the benefits of finding the right intervention or surgery for the right patient will ultimately save one time and money over the long haul. Getting things done right the first time is of paramount importance to achieving optimal outcomes with a high degree of patient satisfaction, while avoiding problems and bad outcomes.
Posted by: Benjamin C. Stong MD
Rhinoplasty is one of the most popular cosmetic surgical procedures performed on the face and one of the most common cosmetic surgeries overall. Rhinoplasty is a very personal surgery because the nose is the central feature of the face. Changing the appearance of an individual’s nose can dramatically change their appearance, improving self esteem and confidence. The improved self image translates into many facets of both personal and professional life. Conversely, a bad rhinoplasty can be disastrous for the patient, and revision rhinoplasty is significantly more challenging for another surgeon. Choosing a rhinoplasty surgeon is of paramount importance to achieve optimal outcomes and avoid problems. Many plastic surgeons advertise that they perform rhinoplasty, but the strength of their training and the techniques they use vary greatly.
Early on in the evolution of rhinoplasty surgery almost all surgeries were performed through a closed technique. With a closed technique, there are no external incisions as all incisions are made on the inside lining of the nose. This gave surgeons excellent access to the upper two thirds of the nose allowing for good control in nasal dorsum surgery, or bridge work, and the ability to take down nasal humps. The lower third of the nose is constituted by the nasal tip and nostrils. With the closed technique, access to the tip is limited and subsequently modification of the tip is more challenging with this approach. There are many surgeons who get good tip results with the closed approach, but the technique left something to be desired and led to the development of the open structure rhinoplasty technique.
Open structure rhinoplasty uses different incisions than the closed technique allowing improved access to not only the tip, but all nasal structures. The open technique places an imperceptible incision in the skin of the partition between the nostrils, called the columella, and along the inner rim of the nostrils exposing all structures of the nose relevant to cosmetic rhinoplasty. This technique allowed for better tip refinement, as well as improved work on the upper two thirds of the nose.
The choice of surgical technique is dependent on the individual’s specific needs and the experience of the surgeon. Some plastic surgeons exclusively perform either the closed or open technique and others perform both techniques, allowing for a more diverse ability to shape and remodel the nose in cosmetic rhinoplasty.
Facial plastic surgeons are extensively trained in head and neck surgery during residency, gaining a superior understanding of both form and function of the nose. Some facial plastic surgeons go on to complete an additional year of training in fellowship where they intensively focus their studies and immerse themselves exclusively in facial plastic and reconstructive surgery. During this additional time they are honing their surgical skills. Dual board certified facial plastic surgeons are board certified in head and neck surgery and facial plastic and reconstructive surgery. Searching for a fellowship trained, dual board certified facial plastic surgeon who is familiar with both open and closed rhinoplasty techniques, will give a patient the greatest chance to find a very well trained rhinoplasty surgeon, with a diverse technical skill set for the best outcomes.
Posted by: Benjamin C. Stong MD
Atlanta, GA
Atlanta Facelift surgeon and facial plastic surgeon, Benjamin C. Stong MD of Kalos Facial Plastic surgery is proud to announce partnership with the Partnership Against Domestic Violence (PADV), the largest domestic violence organization in Atlanta and the state of Georgia. At only 34 years old, Dr. Stong has not only positioned himself locally as a leader in the facial plastic and reconstructive surgery community, but has also managed to dedicate his time and efforts to numerous humanitarian efforts. His most recent endeavor is volunteering to be the exclusive facial plastic surgeon for the PADV, providing surgical assistance to victims of domestic violence. Nearly 5.3 million intimate partner victimizations occur each year among U.S. women ages 18 and older. This violence results in nearly 2 million injuries, some of which can require extensive facial reconstructive procedures, such as Rhinoplasty surgery. Dr. Stong’s training in facial plastic surgery provides the most advanced and contemporary procedures in Facial Plastic and Reconstructive Surgery to restore the self-esteem of domestic violence victims.
Dr. Stong resides on the national FACE TO FACE committee; a humanitarian program of the Educational and Research Foundation for the American Academy of Facial Plastic and Reconstructive Surgery. FACE TO FACE is designed for facial plastic surgeons to donate their time and skills to help those in need of reconstructive facial plastic surgery including: victims of domestic violence, children afflicted with congenital birth defects, such as cleft lips and palates, and wounded veterans of the war in Iraq and Afghanistan. “I was astonished at the number of domestic violence victims presently in Atlanta,” said Dr. Stong. “Most of these victims are not only affected emotionally, but also left with physical evidence of the abusive relationship. My goal is to contribute to the healing process by helping repair their physical and emotional scars. Although this is only an initial step, we are optimistic about helping these survivors of domestic violence as well as provide future support to the PADV.”
Northside Hospital will collaborate with Dr. Stong by waiving facility and anesthesia fees for victim’s surgeries. For 14 consecutive years, Northside Hospital has been voted by Metro Atlanta consumers as the Most Preferred Hospital for Overall Healthcare Services. Additionally, Northside Hospital performs more surgeries than at any other Georgia Hospital.
The PADV’s mission is to end the crime of intimate partner violence and empower its survivors. Since 1975, they have provided professional, compassionate, and influential support to battered women and their children in metro Atlanta. It is a prestigious organization that helps restore victim’s confidence. The PADV also works to end domestic violence by restoring self-sufficiency and control to victims as well as educating the public on the dynamics of this complex issue. Meagan Fulmer, the Vice President of Development for PADV, approached Dr. Stong after learning of his generous contributions to other charitable endeavors. “The PADV is excited to welcome Dr. Stong into our family. To have a surgeon of his skill set willing to work in partnership with us to help survivor’s of intimate partner violence not only overcome their emotional and physical barriers, but also help them thrive through the gift of healing,” said Meagan.
Aside from providing surgical services, Dr. Stong will host a charitable benefit November 4th at the Mason Murer gallery from which all proceeds will benefit the PADV and the national FACE TO FACE program. He and the Kalos Facial Plastic and Reconstructive Surgery staff will also participate in the annual Hearts with Hope signature fundraising event of the PADV. The proceeds from the gala go to support violence prevention, emergency intervention, and long-term advocacy for battered women and children.
Restoring form and function is critical to excellent results in rhinoplasty surgery. The nose must be balanced in proportion to other facial features. In each individual patient, it should be considered in context to the relative size of the individuals facial reference points. Nasal tip projection is classically described as approximately 1/3 the height of the nose with several other specific and sophisticated methods used to describe ideal nasal tip projection. Chin projection can affect the perceived, relative tip projection; a recessed chin creates a nose that appears relatively overprojected, making a chin implant necessary. Additionally, the height of the nose is defined in relation to the height of the midface as well as the height of the upper and lower two thirds of the face, and disproportions in the vertical heights of any of these standard references, can result in facial disharmony. The length of the nose is measured from the root of the bridge to the nasal tip and is changed by affecting tip rotation. These measurements serve as a guide for changing the size of the nose in rhinoplasty surgery and can be tailored based on the patient’s personal ideal aesthetics.
Shaping the intrinsic characteristics of the nose involves changing features such as nasal humps or bumps, the shape of the tip, the angle between the nose and lip, and irregularities and asymmetries between the two sides. True humps are removed to create a straighter nasal bridge or a slight, feminine scoop. Tips that are bulbous and large can be contoured to create a more refined, elegant tip. Additionally weak, flat tips can be bolstered to create a more ideal, defined, aesthetically pleasing tip. The angle between the upper lip and nose is closer to a right angle in men, while in comparison, the angle in women can be up to 115 degrees. Correcting asymmetries between the two sides of the nose can require straightening the nasal bones as well as adding cartilage grafts to camouflage irregularities. Changing the intrinsic characteristics of the nose employs a multitude of techniques culminating in a more pleasing, harmonious, balanced nose.
There are two main approaches to gain access to the nasal structures for rhinoplasty. The first and most traditional way is through incisions contained on the inside of the nose and is called a closed or endonasal rhinoplasty. Not all surgeons are familiar with this approach and may not offer the technique. The primary limitation with the closed approach is with tip contouring and refinement. Although tip suturing can be performed by delivering the cartilages during closed rhinoplasty, the shaping is not performed with the cartilages in their native position making precise changes more difficult and less accurate. There are certainly patients who are excellent candidates for closed rhinoplasty, and patients should be judged on an individual basis with the goals of the patient and the familiarity of the surgeon with this technique in mind. Open Structure Rhinoplasty Surgery has become the most commonly employed technique in rhinoplasty surgery today. It involves a small imperceptible incision in the collumela, the structure that divides the two nostrils. With this additional tiny incision, the nasal envelope can be lifted to gain better access to the bony and cartilaginous structures of the nose, allowing for the absolute best control in shaping and reconstituting the structural elements. In many cases open rhinoplasty is the best technique to achieve the absolute best outcomes, particularly in revision rhinoplasty or when a significant amount of tip work needs to be done.
As with all facial plastic surgery, choosing a surgeon who is knowledgeable and familiar with several techniques is important to optimal surgical planning. Rhinoplasty can be performed in conjunction with other facial plastic surgery, such as a facelift. No single method or technique in rhinoplasty surgery is applicable to every situation. The patient’s goals for surgery are critical to developing an individualized plan. Digital morphing software allows photographic manipulation, making communication between the patient and surgeon easier in order to customize surgical results. Not every individual patient has the same aesthetic tastes and facial proportions. Some surgeons “give” the patient a nose, instead of discussing the possibilities of surgery, and developing a collaborative plan to achieve optimal outcomes with their rhinoplasty surgeon.
Post provided by: Rhinoplasty Surgeon Atlanta GA | Benjamin C. Stong MD