Why Doesn’t My Nose Look Like The Simulation That The Doctor Created Before Surgery? Why Do I Have A Supratip Deformity?

I often see patients who bring with them beautiful simulations that their prior surgeons created to show their intended results, but the noses don’t look like that.  Why not? It is not as simple as poor skill on the surgeon’s part, though good technique certainly makes a difference.  The reason that surgeons have less control […]

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How To Interpret A One Star Internet Review

I am currently co-chair of an aesthetic symposium for the American Association of Plastic Surgeons.  In putting this symposium together, my colleague and I are of course selecting the best surgeons to teach the members of this prestigious organization. As I went to the Internet to find phone numbers, I discovered that most of these […]

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What Is Tip Projection and How Do You Improve It? – Part II

Last week I defined tip projection.  Here is an explanation of how to correct inadequate projection: The photo in the middle illustrates inadequate tip projection: the tip is held up by the height of the bridge.  The photo on the right shows the surgical correction after I have reduced the bridge and increased tip strength […]

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What Is Tip Projection & How Do You Improve It? — Part I

Tip projection is a term that surgeons use all the time, but that still confuses many patients and surgeons. Some of this confusion is inevitable because so many surgeons perform open rhinoplasty.  If the skin is not connected to the nose and under its usual tension, it is simply impossible to understand or assess tip […]

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Finding the Missing Ingredient in Many Cleft Lip Repairs

Just two weeks ago I operated on a teenager born with a cleft lip.  Frequently the nose is also involved in some patients come for secondary corrections when they are old enough. In addition to the shape of the tip and nostrils, one of the frequently-neglected reconstructive steps is fixing the position of the upper […]

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