Breast reduction is perhaps our highest-satisfaction surgery for our patients. Lighter and lifted, with a natural contour. Back and shoulder pain, and strap grooving, tend to improve immediately. Especially for our younger patients, confidence and comfort noticeably rises. Exercise and daily activities also get easier. It’s a commonly sought-after procedure for a reason! For more, visit our Breast Reduction page … Read More

1 month follow-up for this cutie after his cleft lip repair. Some of our families decide to go home the same day as cleft lip repair, and others choose to stay a night for observation. Either is safe and reasonable for almost all of our patients without other medical conditions / syndromes. If your surgeon decides to perform an anterior … Read More

While I prefer to repair a cleft lip and palate after NAM (nasoalveolar molding) that brings the two sides closer together, a single-stage repair is still possible with adequate release of the muscle, and release and reconstruction of the nasal sidewall. A lip adhesion (2-stage lip repair) may have been offered by some teams, but I’d prefer to do this … Read More

One of our cleft cuties growing up all too quickly! Cleft lip repair normally is offered at 3-6 months of age. Palate repair then follows at 9-12 months of age as speech development speeds up. This can also be a good time to perform a tip rhinoplasty while under the same anesthetic, to bring the nasal tip closer together, and … Read More

This patient can breathe like never before! She has had several previous surgeries on her nose by other surgeons. Unfortunately, she had severe nasal obstruction and apnea. She also hoped for improved nasal symmetry. We performed an open cleft rhinoplasty, including release of scar tissue and reconstruction with multiple cartilage grafts (spreader, septal extension, columellar strut, lateral crural strut, and tip grafts). MTF … Read More

“It’s not a big deal to be able to breathe… but it really is a big deal. The left [nostril] especially works well.” She has a history of previous surgery but had chronic problems breathing through her nose. Closed septorhinoplasty (*no incision* across the columella) was done. Key maneuvers included septal resection, spreader and caudal septal extension grafts, and tip … Read More

Nasal obstruction and a history of trauma? We can definitely help you breathe and sleep better, and straighten your nose. A gentle hump reduction and contouring of the dorsum can be done at the same time. Here, preservation techniques to bring the nasal bones down, and component septal resection and spreader grafts, all work together for a natural result at … Read More

He came to me with longstanding trouble breathing despite years of different medications and sprays. While correcting the deviated septum, we used that cartilage to make spreader grafts that support the airway further. We also opted to bring his dorsum down, but kept it masculine and not too upturned. His swelling is about half way down at this 1 month … Read More

Secondary rhinoplasty is a welcome challenge in my practice. This patient communicates beautifully and expressively with her eyes and smile, but her nose was distracting and causing progressively worse breathing problems. Anatomically, her septum and columella twisted to the left, and her lower lateral cartilage on the left with asymmetric amounts of lateral crural steal and medial crural excess. After … Read More

Functional rhinoplasty should also work hand in hand with your aesthetic goals. Here, a deviated septum and narrow internal nasal valve were corrected with a septoplasty and spreader grafts, improving her nasal breathing. The dorsal hump was brought down and smoothed as planned. Under the hood, the turbinates are little humidifiers inside the nasal passages. These little outcroppings can be … Read More

Secondary nasal reconstruction after old trauma or rhinoplasty surgery falls into that overlap of 1) what I enjoy doing, and 2) where we get consistently satisfying results. This patient had a previous trauma with reduction of the fractures done appropriately after her injury. Unfortunately, over time the deviation and airway collapse continually worsened. Open approach, structural rhinoplasty was required to … Read More

Septorhinoplasty is usually the final surgery for a patient born with a cleft lip. A few things combine to create common complaints: 1) Inherently different/less growth potential 2) Asymmetric and/or abnormal attachments of muscles and ligaments 3) Bony asymmetries 4) Scar tissue 5) Abnormal blood and lymphatic flow These inevitably lead to problems breathing, and often thick and scarred nasal … Read More