Very few surgeons are truly qualified to perform the complicated procedure of Revision Rhinoplasty. Revision or Secondary Rhinoplasty is a correction, whether functional or aesthetic, to the unsatisfactory results of a previous Rhinoplasty (Nose) surgery.

WHEN TO GO FOR THE REVISION… Typically, the recommendation is to wait a year after the original Rhinoplasty so that there is ample time for healing and the nose to “settle” into its new anatomy. There can be a shorter duration to this recovery time depending on the extent of the previous surgery, which can be discussed during the consultation.

Although the decision should not be made lightly, you should consider a revision if you have any of these issues:

• persistent breathing problems
• nose still too large
• still a bump in the bridge
• new nose not in balance with the rest of the face
• too much removed
• tip of your nose needs better refinement
• tip is deflected off to one side (“twisted tip”)

WHY IS REVISION RHINOPLASTY MORE COMPLICATED?

• Changes to the typical anatomy and geography of the nose due to cartilage removal during the first surgery
• There may not be enough cartilage in the nose to work with and it has to be borrowed from behind the ear, which also requires extra incisions
• Navigating the scar tissue in the nasal lining from the primary surgery
• There is a higher risk of developing little spider veins in the nose called telangectasias
• All of these issues increase the variables and the amount of time in surgery

SURGICAL EXPERIENCE IS CRUCIAL… It is possible that the problem resulting from the original Rhinoplasty may not be the fault of the original surgeon. Anatomical variations and the healing process aren’t under their control. Although, the actual surgery is under the surgeon’s control, which is why you need the most experience surgical hands for the best possible outcome. This is especially true with navigating the altered anatomy and scar tissue present during a revision Rhinoplasty. It requires not only skill, but an artful eye, as well.

CHOOSE A SURGEON WHO:

• IS Qualified with expert training (I’m triple board certified in Otolaryngology/Head and Neck surgery, Facial plastic & General plastic surgery)
• Has many years of experience with many surgeries (almost 2 decades of surgical experience)
• Does them regularly – Our patients come from across the country to have revision rhinoplasty  – using my advanced techniques and honed skills…

This is one of those surgeries where the extra care and attention I give to my clients is crucial for discussing expectations, changes and the best technique to accomplish the goal of the Revision Rhinoplasty. To schedule a consultation to get the nose you desire, visit www.davinciplastic.com.

Steven Davison M.D.

Baord Certified Plastic/Reconstructive Surgeon

LONG LASTING FACIAL MAKEOVERS

Hollywood has taught us much about keeping our youthful appearance until we die.  Long lasting facial makeovers create or restore facial symmetry, which is crucial to looking young.  Symmetry involves achieving balance between the facial thirds…upper face (eye/brow/forehead), middle third of the face…nose and cheeks and the lower third includes the lips, chin and neck.

THE CHIN & FACIAL BALANCE…CRUCIAL TO YOUTHFUL APPEARANCE

Today, let’s get back to the chin. A sharper chin restore balance, proportion and definition with the middle face,particularly the nose.  Chin implants are often used in a more aged chin to restore lost volume and shape. A sharper, well defined chin is in direct contrast to a chin that has “receded into the neck.”

CHIN AUGMENTATION USING IMPLANTS

Chin Augmentation is a minimally invasive, quick, little or no downtime procedure done in my office.  I make a small incision either in the mouth or right under the chin and work through it to create a pocket for an implant.  Once in place, the implant makes you look years younger forever.

BENEFITS OF CHIN AUGMENTATION:

• Chin Augmentation with implants is safe & effective
• Implants add definition to the jawline…
• Overall facial balance is improved…
• A more youthful appearance is created (for some) or restored
• Liposuction may be part of the process to sculpt the chin & neck
• Neck proportions are readjusted by manipulating/tightening muscles
• I customize implants to meet your specific needs/ & goals

• Patients often decide to combine Chin Augmentation with other facial procedures to optimize their results
• The procedure takes about 30 minutes or a little longer
• There is often no downtime
• I use state of the art instruments & the most advanced but safest techniques

FUN IN THE SUN REMINDERS!

We’re coming into summer so PLEASE remember the skin protection tips I offered in my last two blogs!  Now

 STILL TIME TO REJUVENATE….

If you are looking into the mirror and noticing any of the things I’ve discussed…let’s talk about your FACIAL REJUVENATION now…there’s still time to do some things before summer vacations.

I’m here to help you keep your best face forward!

Dr. Steven Davison

At DAVinci…I combine the supreme elements of art & surgical science.

AGE DEFYING AUGMENTATIONS: the Chin is in

Chin augmentation is currently the most “in demand” anti aging cosmetic procedure being done today.  Among all demographics, it is the fastest growing trend according to recent survey results from the American Society of Plastic Surgeons.

Here are the numbers:

– Chin augmentations increased overall by 71% in 2011

– Chin augmentation outranked breast procedures in 2011

– Men of all ages – 76% increase

– Ages (both genders) 40 to 54 – 77% increase

– Ages 55 & over – 70% increase in Chin augmentations

– These numbers were in comparison to lip augmentation, breast augmentation and cheek implants, clearly showing that people saw the need to correct aging in the lower 1/3 of the face.  Chin Augmentation restores the neck and chin to a more youthful appearance by reducing the sagging jawline, often with a chin implant and correcting the neck issues.

So what’s the reason for this dramatic change?  Surveys also revealed that as more and more people are chatting online with camera’s rolling…they see the receding chin and sagging jawline since it shows facial aging very early.

Baby Boomers especially, are showing up in aesthetic surgeons offices seeking ways to turn back the clock with Chin augmentation or a combination of age defying options.

Concerns over their careers prompt many to have combination treatments such as Botox and liposuction, while others choose chin implants and neck lifts…or all of it.

Cameras don’t lie! The more time people spend in front of cameras on their PC’s…the more we see them asking me to take years off their face,  to explain chin augmentations, facelifts, injectable facelifts, Botox, liposuction & sculpting of the chin/neck to restore its youthfulness…and much more.  Read more about these: www.davinciplastic.com.

Chin Augmentation is in…but I also have many other tools in my tool chest.

Got concerns about facial aging?  Let’s talk.  There are many non surgical options we can explore so that you can be happy with your camera look.

Next blog will overview facial aging and the chin and neck…and how chin augmentation takes years off the face.

Dr. Steven Davison

At DAVinci…I combine the supreme elements of art and surgical science.

BEAUTIFICATION…BALANCE…SYMMETRY….Stage III

The goal of all breast reconstruction (restoration) surgeries is to achieve symmetry and balance between both breasts and also for them to look “natural.”  Beautification is started several weeks or months after your reconstruction process is complete and you have healed nicely.  Beautification involves creating balance between the two breasts, breast contour, adjusting flaps if needed, and nipple/areolar reconstruction.  Sometimes, women choose this phase, of their breast restoration process, to include other breast procedures such as a Breast Lift or Breast Reduction.  My goal is that: “all  cosmetic surgery should be functional…and all reconstructive surgery should be aesthetic and look as natural as possible.”

My patients are living testaments to the benefits of having restorative procedures following mastectomy surgery.  Here are just a few of their comments:

“I love being able to wear off the rack clothing since you completed the beautification process and now my breasts are symmetrical and so natural looking.”

“My husband is so glad to see my level of self confidence and a sense of normal self restored again.”

“The breast reconstruction did more than restore normal looking breasts….it restored my self confidence and has allowed me to return to the lifestyle I love…and the love of my life!”

We will discuss your goals for Stage III Beautification in detail.  After decades of helping women through this process…I’ve been able to help them through the challenges…by removing fear and replacing it with knowledge and self empowerment.

STAGE IV…NIPPLE TATTO…this is just as it says…nipple tattooing to create a natural looking nipple and areola on the breast(s).  This process further beautifies the breast by defining the dark area of skin surrounding your nipple(s) and areola(s).

Regardless of when you begin the process of reconstruction/restoration…. I use the most advanced but safest methods along with finely honed techniques.  By combining my meticulous skill with my thorough understanding of the intricacies of the human anatomy, my patients enjoy amazing outcomes that are both functional and beautiful.  You can read more about this entire process at: www.davinciplastic.com

Well, here’s my chance to “shine” a bit. I don’t usually hang out or post my “brag sheet”…but being recognized among the top doctors of the nation can make a guy feel proud.  In case you’re not aware…I’ve been named as a “Top Doctor” of the Year by the Washingtonian,  the Northern Virginia Magazine, and others, for Reconstructive Breast Surgeries.  Along with that award, top docs must assume great responsibility.  First let me explain the selection process.

Castle Connolly Medical Ltd. is America’s trusted source for identifying top doctors and the best in American medicine.  Their system for selection is rigorous and includes ascertaining critical information about doctors such as: exceptional training, experience and how they are regarded by their peers etc. etc. Top Doctors can have an enormous impact on healthcare for patients and their families….a “Top Doc” can mean the difference between receiving first class medical care and substandard care.  Top Docs rank among the top 10% in the Nation.

The Washingtonian and Northern Virginia Magazine also use these rigorous guidelines for selecting “Top Doctors”…or “Top” anything e.g. restaurants.  Education (not all schools are equal), experience can make a major difference in outcomes, and most important of all…life changing procedural results that patients are happy with, along with peer recognition (being recommended by other doctors)…comes only from years of growing and honing skills while keeping up with advancements.  This is the stuff Top Docs are made of.

 I love what I do, and the greatest reward is always seeing positive outcomes for my patients.  

I am honored and blessed to be able to serve the population in and around Washington, D.C. and I thank each of you for your  years of trust, confidence and support you’ve shown to me and my family.  I look forward to many more years of helping each of you, and your family and friends…and to enjoying the friendships that grow as a result.

Thank You, Stay Well and may God richly bless each of you.

Steven Davison, M.D.

At DAVinci…we combine the supreme elements of art & surgical science.

STAGE I – Mastectomy & Expander

Breast Reconstruction usually occurs as a two-stage procedure – starting with the placement of a breast tissue expander – which is replaced several months later with a breast implant. Dr. Davison will place the tissue expander under the same anesthesia as your mastectomy surgery if possible. This is called immediate reconstruction since the process is started at the time of your mastectomy.  You may choose to “delay” the start of reconstruction and wait for a few weeks or months.  This is called delayed breast reconstruction.

Here are the steps involved in mastectomy with expanders:

1.  During the mastectomy your breast surgeon removes skin and breast tissue – leaving the chest tissue flat and tight.  An expander (balloon type expandable device) is put into place under the chest muscle and skin – to serve as a space saver – into which a breast implant is later placed.  The expander is gradually filled with saline solution – over several weeks – and slowly stretches the remaining chest skin and muscle to allow for the future breast implant.
2.  Expander surgery is performed under general anesthesia in an operating room. Often a Biologic tissue barrier is used to create an inner Bra to cradle the expander.
3.  The incision used to perform your mastectomy is used for the expander placement
4.  After placement – the incision is closed
5.  Drains are left in place – and are removed when only 30cc fluid comes up
6.  Healing takes 4-6 months – the surgery takes several hours and is done under one anesthesia.  If delayed expander placement is done – surgery takes 1-2 hours.
7.  Breast implant is placed when Dr. Davison determines the space is sufficient and the expander is removed.  The same incision is used to do implant placement.
8.  A nipple and areola is created typically 3 months later – with additional beautification for both breasts.
9.  Dr. Davison becomes your primary care physician over the next year during this entire process.

BREAST RECONSTRUCTION …in STAGES

Reconstructing a breast is an option chosen by hundreds of thousands of women, around the world, every year due to cancer or other trauma. The techniques we use today are more advanced allowing for less downtime, quicker healing and more natural looking outcomes. The procedure can be done in either one or two stages. I cover Stage I today.

STAGE I:  involves an “tissue expander’ that is inserted immediately following mastectomy.The expander slowly expands the tissue allowing for replacement by a breast implant a few months later.This is called immediate reconstruction since the tissue expander is placed under the same anesthesia as your mastectomy surgery.

Many women choose immediate reconstruction. Others opt to wait a few weeks or months. This is called delayed breast reconstruction.

One decision does not fit all women. Opting for breast reconstruction and the timing…is highly personal. My sensitive nature and expertise has enabled me to help many women make the wise decisions to overcome this otherwise daunting task. My patients quickly understand their options and learn how natural looking form/function and confidence can be restored.

If you or someone you know is faced with this challenge…let’s chat. During the personal consultation, I carefully listen to concerns, desires and goals before making recommendations. My experience enables me to achieve predictable and natural looking results.

IMPORTANCE of BOARD CERTIFICATION & SPECIALIZED TRAINING

Choosing a board certified surgeon, with specialized training and experience in reconstructive surgeries is critical to achieving desirable outcomes. I have the credentials, training, vast experience and many, many happy, healthy patients.

Next blog will cover Stage I…what’s involved.

Dr. Steven Davison

“At DAVinci…We combine the supreme elements of art and surgical science.”