Why Open Rhinoplasty Keeps Getting More Complicated – Part Two

Every year, open rhinoplasty has gotten more complicated, with more steps, wider dissections and disruption of normal nasal architecture, and more complex suture and grafting techniques.  The upshot of all of that dissection is more postoperative swelling and even skin loss from poor circulation. What is important to note in all of these procedure changes […]

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Why Open Rhinoplasty Keeps Getting More Complicated – Part One

Open rhinoplasty had its resurgence in the mid 1980’s to help surgeons perform techniques that they found too hard through the lining—the way it had been done for a hundred years.  The open procedure was originally simple: the same closed operation, but through an external columellar incision. The principal was this: If the surgeon can […]

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Personal Identity

A recent patient illustrates multiple points necessary to have a successful rhinoplasty. This gentleman originally had a badly traumatically damaged nose, the result of parental physical abuse.  That is an important point.  He underwent surgery that straightened his nose and profile, removing the bump.  The result seemed good, but the patient was angry and unhappy. […]

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How Form and Function Cooperate in Rhinoplasty

This very nice lady (whose identity is protected but whose nose is shown in the accompanying 4 photographs) is a perfect example of several of the principles that I teach and practice. A surgery many years ago, reducing the height of her bridge and tip, collapsed the middle third of her nose, impairing her internal […]

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Self-Esteem & Plastic Surgery

I just answered a letter from a young woman who had sent photographs of herself, explaining that she had “low self-esteem from sunken eyes and a bumpy nose.”  She wondered what plastic surgery could do for her. I have answered many inquiries in the past, but two things made this one different: first, most patients […]

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