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

Do you have trouble breathing through your nose? One of the possible causes is a deviated septum. This can happen as a result of genetics or an impact caused by an accident or athletic event. A deviated septum makes breathing difficult because the bone and cartilage that is supposed to be down the center of the nose that divides the nasal cavity in half is crooked or drastically off center.

• The best way to confirm a deviated septum is to see a specialist like myself. The following are common symptoms of a deviated septum:
• nasal congestion on both sides or one side being more congested than the other
• difficulty or loud breathing
• repeated sinus infections or constant postnasal drip
• aching in the head or face
• issues with breathing during sleep, such as snoring or sleep apnea
• nosebleeds

The specific surgical procedure to fix a deviated septum is called a Septorhinoplasty.
TREATING A DEVIATED SEPTUM

Septoplasty is often combined with Rhinoplasty, or nose job, to correct the external effects of the crooked insides. The combination of these two procedures is called a Septorhinoplasty. Rhinoplasty is one of the most common surgical procedures and in the hands of a skilled surgeon like myself, the results can help you breath easier from both physiological and aesthetic improvement. Anyone in good overall health is a candidate, although for children needing septoplasty, it is preferable to wait until after the nose has stopped growing around age 15.

WHAT DOES SEPTORHINOPLASTY INVOLVE?
Septoplasty: By working through the inside of the nose, a small incision is made in the septum. The breathing canals of the nostrils are evened out by removing the excess bone or cartilage. Soft gauze or internal splints stabilize the nose as it heals.
Rhinoplasty: This portion of the procedure corrects any cosmetic imbalances in the bridge or nostrils to improve the nose’s appearance and overall harmony of the face. This recontour of the nose improves functionality and appearance to give optimal performance and confidence.
Both are performed on an outpatient basis and using either intravenous sedation or general anesthesia, depending on the patient’s health conditions and preferences.
RECOVERY… Oral pain medication will help mitigate the discomfort from either surgery. Septoplasty recovery should be within a week. Rhinoplasty recovery from bruising, swelling, and incision healing is longer than Septoplasty alone. It’ll last about a week or two, although some people can return to work after 1 week. Either way it’s recommended to rest of the head elevated to help with swelling. Even after the initial Rhinoplasty recovery of about 2 weeks, patients should refrain from intense exercise and contact sports for at least 1 to 2 months. This makes it imperative for athletes to correct their deviated septum in the “off season.”
Whether you’re just having trouble breathing or would also like to improve the external appearance of your nose, we can discuss which surgery technique is best for you. Please visit www.davinciplastic.com to schedule a consultation.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

Men and women of all ages have a myriad of age reversing, rejuvenating options from which to choose.  Each option offers its own unique benefits.  Choosing the right one or combination of options involves figuring out what’s best for your needs and not someone elses.  No “cookie cutter” treatments offered here. MEN ARE GETTING TREATMENTS NEARLY AS OFTEN AS WOMEN.  NO MORE TABOOS! Careers demand it and Generation X chooses to include cosmetic procedures as part of their normal health maintenance regimen because they want it.

AREAS of FACIAL AGING… THE EYES show signs of aging early.  These signs include: lines, wrinkles, furrows, hollows, severe under eye bags, sagging upper eyelids, forehead parenthesis and furrows and skin that is losing elasticity (crepey looking).

Treatment Options include:  Injectable fillers for volume replacement, to encourage collagen renewal and restore contours; Botox to stop lines and wrinkles from forming and to smooth out the skin, Blepharoplasty and Browlift surgery to correct both the upper and lower eyelids by removing excess skin, excess fatty deposits, to lift brows back up and restore youthfulness to the forehead and brow/eyes.

Blepharoplasty surgery corrects severely drooping brows and hooding of the upper eyelids. When fillers and Botox no longer work or treatments are started too late, Eyelid surgery is the best option, especially if excess skin is undermining your vision. In this case, it is done for “functional” purposes as well as cosmetic restoration.  Men, especially, seek out eye surgeries to correct these problems, to look and feel younger and healthier.

CHEEKS OFTEN BECOME FLAT, SUNKEN and SAGGY – CHEEK AUGMENTATION is among today’s most popular age reversing options.  For flat, sunken cheeks both hyaluronic fillers and collagen stimulating fillers can add dimension and nice definition.  Augmenting the cheeks improves the appearance of the eyes by addressing volume loss.   Often fillers work and if not cheek implants will. Sagging cheeks require surgical lifting and tightening of the underlying muscle and tissue and is often coupled with  injectables for ultimate and long lasting results.

INJECTABLE FILLERS and SURGERY   Injectable fillers usually offer immediate and ongoing results as collage production is stimulated and hyaluronic acid fillers replace volume by attracting water.  Surgery results can be subtle or dramatic and last indefinitely.

NOSE and RHINOPLASTY SURGERY vs FILLERS   Injectables can correct certain nasal deformities and small irregularities. For example, we can add height to make a hump less noticeable. A good looking nose improves the facial profile allowing certain features to pop out more.  Surgery is needed when there are functional issues and flaws that fillers can’t handle. Injectables are amazing, but are not curealls.  https://www.davinciplastic.com.

NOSE FLAWS MEN WANT CORRECTED include a deviated septum, bulbous nose tips, crooked noses from being broken, pitted and scarred areas, humps and bumps from injuries or birth and others. Functional correction is key with men.  They don’t like noses that don’t work right.  So, I do many Rhinoplasty surgeries and non surgical nose jobs also.

Remember the “fun in the sun” tips….lots of water to drink (stay hydrated), sun screen, umbrellas, anti oxidant snacks like raw fruits, sun glasses, avoid glare from the water…the sun is hottest between 11:00 am and 2:00 pm.

MOMMY MAKEOVERS for WEDDINGS, GRADUATIONS, CORPORATE MEETINGS,  PTA, FAMILY REUNIONS, CLASS REUNIONS, FOR YOURSELF.  Let’s get you scheduled and looking/feeling great again.

Best to you and yours,

Steven Davison M.D.

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

Since I’m specially trained and very experienced in reconstructive and revision surgeries I do a lot of “Nose Jobs.”  Patients of all ages, stages in life and from all cultures come to me because they are unhappy with a previous nose (rhino) surgery.

Rhinoplasty surgery is done to change the size, shape  and form of the nose and/or to correct functional problems such as difficult breathing caused by a broken nose (deviated septum), fracture or disease.  So, when the outcome from a nose surgery is not desirable, often I am asked to fix it.  Following are some very important points you need to know and understand about revision nose jobs.

Revision Rhinoplasty is always more challenging than the original (primary) rhinoplasty surgery.  Several reasons for this are as follows:

1. The geography of the nose was altered during the first surgery.  This involved removal of cartilage which provides form and structure for the nose
2. The cartilage needed for the revision surgery must then be borrowed from someplace else
3. An extra incision is required to allow for borrowing the needed cartilage
4. The nasal lining has typically turned to scar tissue in the operated nose
5. Risk of little spider veins increases with a second surgery (telangectasias)
6. Revision Rhinoplasty is very complex and detailed since nasal form has to be restored and function (breathing mechanisms) have to be repaired
7. These challenges increase the time involved in the surgery
8. Very Few surgeons are qualified to perform these highly specialized revisional surgeries

Even though Revision Rhinoplasty has its own set of unique considerations, it is among the most rewarding of all surgeries.  The nose is the most prominent feature on the face so getting it right is most rewarding to people having this surgery.

HOW I PERFORM REVISION RHINOPLASTY:  There are 2 methods used for nose surgeries:  Open Technique and Closed Technique. Open involves incisions made inside the nose and 1 under the nose between the nostrils.  Closed means incisions are inside the nose only.

Revision Rhinoplasty surgery is frequently performed using the open approach which allows for more “complex” nose jobs to be corrected with natural looking, desirable outcomes.  Borrowed cartilage is taken from behind the ear, when needed,to restore nasal form and function.  This incision is well hidden.  The under the nose incision is barely visible and fades to a very faint thin line over time.

Here are 3 frequent questions I’m asked:

1. About anesthesia…I use local with sedation or general.  We determine that during your consultation to choose what’s best for you.

2.  Who can have Revision Rhinoplasty?  Men and women of all ages (must be in good health) and teen boys and girls who are fully grown.

3.  How long does the surgery take?  This depends upon the complexity involved.  It could be from 45 minutes to 3 or 4 hours.  The important thing here is to achieve a pleasing outcome with restored function.

These are the top three questions.  The rest are on my website: https://www.davinciplastic.com.

If you have nose problems from a previous surgery and have been afraid to approach it again…let’s talk.  I am specially trained in these surgeries and have been performing them for years. I still perform them on a regular basis using today’s most refined instruments and techniques…those that are proven safe and reliable. My patients get the results they desire and deserve.

HAVE FUN in the SUN.  BUT REMEMBER THE HATS, GLASSES, SUN SCREEN, WATER, UMBRELLAS ETC.

Steven Davison M.D.

“DAVinci…where I combine the supreme elements of art and surgical science.”

Long Lasting Facial Makeovers…Nose Jobs

Well, I’ve been getting you up to speed on long lasting Facial Makeovers, using techniques that effectively remove 10 years from your face, and keep you looking years younger always.  Today, we look at the importance of the nose and how aging affects it and…facial balance.  Nose jobs (Rhinoplasty) is one of the most elegant surgeries performed and can dramatically restore youthfulness, symmetry and balance to any aging face.

Why Rhinoplasty?  Each year hundreds of thousands of men and women decide to have their noses reshaped, repaired and done over for a host of reasons including: injuries that caused a deformed nose and hindered normal nasal function and/or left the nose misshapen (Deviated Septum) etc. Noses change with aging causing a droopy tip or bulbous tip, there may be humps and bumps or “ski slope” appearance; the nose may be too wide, to narrow, too weak and much more.  All these and other concerns  about form and function affect overall facial appearance and often…self esteem suffers.

Facial Balance & the Nose…When the nose is a problem (see above) it usually affects facial balance and symmetry…which is crucial to looking young.  Also, an out of balance nose can highlight a weak chin or other facial defects.  Bringing the nose into correct balance and proportion for your face is done by correcting size, shape and position.

The nose is the most defining characteristic on the face…for this reason nearly one million Americans have nose jobs every year.

Benefits of Nose Reshaping (Rhinoplasty) include:

• To create or restore function
• Give you the nose you’ve always wanted and never had
• Change the size, shape & position of the nose
• Create a more youthful overall facial appearance
• Achieve a harmonious blend with your other facial features
• Can be combined with other facial procedures to optimize your results

There are a host of reasons people come to me for Rhinoplasty (Nose) surgery. These include, but are not limited to, injuries…sports, accidents etc., illness or disease that has changed the shape and functioning of the nose,…or people simply want the nose of their dreams.  Whatever the reason, I am specially trained in all cosmetic and reconstructive surgeries of the nose and face and have performed a host of nose surgeries.

Since, I’ve blogged quite a bit on “facial” procedures, I think it’s important to educate you on surgeries of the nose because…

Rhinoplasty is one of the most elegant and complex surgeries being performed today. People of all ethnicities, genders and ages/stages in life decide to have rhinoplasty surgery for one or more reasons.

Rhinoplasty…Nose surgery… is done for either cosmetic or functional reasons and sometimes for both reasons.  Nose reshaping can reduce or increase the overall size of your nose…change the angle between the nose and upper lip…remove a hump…narrow the nostrils span…reshape the tip or the bridge of your nose….and more.

Sports injuries of the nose are common and usually result in a deviated septum…this hinders your ability to breathe and changes the facial landscape…often dramatically. Sometimes a nose becomes distorted from disease or illness…or an accident…or even previous nose surgery at the hands of an unqualified professional.  Some people were born with misshapen noses….other people watch their noses changes size and shape as part of normal aging.

The concerns and reasons are many and varied. However, I have been helping people with their nose problems for decades now….and can safely, effectively and skillfully improve the appearance of a nose.

HERE’S A SHORT LIST OF THE BENEFITS OF RHINOPLASTY SURGERY:

• Rhinoplasty is a delicate surgery…a surgery of illusion & balance
• The nose is the most focal point of the face & adds or subtracts from facial balance
• Over 1/2 million people of all ethnicities, ages, genders have nose surgery
• Seniors often want their noses restored to a more youthful size & shape
• Rhinoplasty restores function to an injured nose (deviated septum etc.)
• Rhinoplasty can change the size, shape & or angle of the nose
• Rhinoplasty corrects damage from previous nasal procedures
• One “nose job” does not fit all faces…I skillfully create a nose that fits your face without altering ethnic characteristics…

That’s a good start or overview on Rhinoplasty.  I use the most advanced techniques and technology to achieve the desired results and the enhance youthfulness and natural beauty.   Next time I’ll get into FAQ’s…and procedure overview.

Until then, stay well and watch out for “nose jobs.”

Dr. Steven Davison

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