This mother of 4 had extra skin and a diastasis – or separation – of the rectus muscles that make up the six-pack. Tummy tuck with excision of 2.5 pounds of extra skin, repair of the diastasis, and some targeted liposuction, helped to improve her contour and confidence. She is seen at just 4 weeks, with swelling set to improve … Read More
I keep tummy tuck patients for observation overnight.
2 months after fleur-de-lis tummy tuck. Re: Recovery — I keep tummy tuck patients for observation overnight. This helps with pain control, care of drains as needed, early walking, and receiving a blood thinner shot 8 hours after surgery. The biggest risk I worry about is a blood clot (DVT) that can travel from the legs up to the lungs … Read More
A tummy tuck was also done to remove excess skin from the lower abdomen and tighten the abdominal wall.
An augmentation/mastopexy is offered when goals include both breast lift surgery and breast volume maintenance or augmentation. The further the nipple/areola needs to be raised to reach the goal position, the higher chance of wanting a revision (~30% in some series), or even planning a 2-stage surgery from the outset. Here, a modest 250cc implant placed under the muscle added … Read More
Early post-op results after a cleft rhinoplasty.
Early post-op results after a cleft rhinoplasty. Bringing the alar base forward is especially challenging if not released and augmented at the time of the primary lip repair. Volume can be added with a rib cartilage graft (self vs MTF), but the lining required release and some recruitment from the surrounding tissue. The asymmetry in the lower lateral cartilages can … Read More
1 month after cleft rhinoplasty and scar revision.
1 month after cleft rhinoplasty and scar revision. Main goals Breathe better Appear more symmetric Refine the tip The septum tends to follow the cleft palate posteriorly, blocking the nasal passage on that side. Anteriorly, the septum is usually pulled to the noncleft side by an imbalance of muscle attachments to the caudal septum. Resetting/resecting the septum helps improve those … Read More
Here, septoplasty, multiple grafts (spreader, lateral crural strut, septal extension, and tip), all work together to provide a more symmetric and projected framework.
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
Here, the upper jaw required greater than 10mm of advancement to correct his occlusion.
The timing and techniques used for our patients with clefts are tailored to each patient. Here, the upper jaw required greater than 10mm of advancement to correct his occlusion. Thus, we performed a Le Fort 1 internal distraction: the maxilla was mobilized, and hardware placed to gradually bring the bone and teeth forward 0.5mm at a time. This incremental movement … Read More
Cleft rhinoplasty for adults – one of the tougher surgeries we do, but also one of the most rewarding.
“I’m actually breathing on both sides now. It’s incredible to be able to do that. “The amount of symmetry on both sides that you were able to achieve really impressed me. “I’m very, very happy with the results.” Cleft rhinoplasty for adults – one of the tougher surgeries we do, but also one of the most rewarding. Here, a previous … Read More
Being able to breathe through your nose depends on enough room through the nose, into the throat, and down into the lungs.
Being able to breathe through your nose depends on enough room through the nose, into the throat, and down into the lungs. There must also be enough strength to keep the walls from collapsing in. Here, the biggest problems were blockage by a deviated septum, and scar tissue from a lifetime of previous cleft surgeries. The scar tissue can be … 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.
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
Correction of the deviated septum – and use of the septal cartilage grafts to the dorsum and cleft side of the ala – greatly improved his breathing.
This young man has done very well with his history of cleft lip and palate surgeries throughout childhood, and he came to us for his cleft rhinoplasty. First and foremost, he had difficulty breathing because of a deviated septum. From the front you can see a slight deviation of the bridge of his nose extending to the tip. As it … Read More
I performed an open rhinoplasty, with straightening of his septum and use of the septal cartilage along with ear cartilage to straighten and support his nose.
This young man has a history of a cleft lip and palate, with septal deviation and nasal collapse. I performed an open rhinoplasty, with straightening of his septum and use of the septal cartilage along with ear cartilage to straighten and support his nose. His breathing and symmetry is already much improved at 1 week after removal of his … Read More