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We Know Noses – Inside and Out!

RhinoplastyRhinoplasty, or surgery to improve the nasal appearance, is the most challenging and complex of the facial plastic procedures done through our office. The self confidence achieved with a natural appearing, properly functioning nose can provide a lifetime of gratification for the patient. With time and experience, I have developed a real passion for this type of surgery.

A solid training and background in nasal anatomy and physiology is necessary to obtain consistently excellent results in Rhinoplasty. Form and function have to co-exist with nasal surgery, i.e. the appearance and the airway must both be good. I have had over thirty years experience in the Arlington Heights area with reconstructive nasal procedures including surgery for cancer, trauma and cleft lip/cleft nose deformity. I have had similar experience in diagnosing and treating patients with airway, sinus and snoring conditions using office endoscopy for diagnosis and endoscopic sinus techniques in surgery. I believe that this background, the constant analysis of facial aesthetics, and continued surgical experience helps me to achieve satisfied patients in aesthetic or cosmetic Rhinoplasty.

Whether a patient is seeking a Rhinoplasty or a Rhinoplasty Revision of another surgeon's result, a consultation in our Arlington Heights office includes a thorough history, physical exam and photographs. Nasal endoscopy and a CT scan of the nose and sinuses are done when indicated. This approach helps us to diagnose airway problems and detect sinus disease, and it also helps many of our patients obtain some insurance coverage for their Rhinoplasty. A detailed analysis with diagrams, illustrations and multiple photographs is done at the time of the consultation so we can not only present to the patient what I recommend at surgery, but also obtain the patient’s input regarding their deformity and appearance. The nose must fit the face and facial harmony with balanced profiles is sought; at times, chin augmentation may also be recommended. An opportunity to view the results of other Rhinoplasty patients is available. Only patients who have given permission for their photographs to be shown are presented to prospective patients. We are now showing pre and post operative photographs on our website. Surgery is only scheduled when both the patient and I have a clear understanding regarding the goals of surgery. Additional visits at no charge may be required to reach this understanding.

Tried and proven techniques in Rhinoplasty are used in our practice. In the past, most Rhinoplasty was of the reduction method, i.e. tip cartilage was removed and the nasal hump consisting of cartilage and bone was removed. Each surgical maneuver or step in Rhinoplasty has consequences and therefore many early good results developed later deformities. We believe that it is very important to strengthen and support tissues during Rhinoplasty so later problems are minimal. The use of cartilage suture techniques and autogenous (the patient’s own) cartilage is routinely used to achieve these results. For patients with major tip deformities and asymmetries, large deflections and major grafting (cartilage) requirements, the Open or External Approach is used. This involves a small incision on the skin between the nostrils to maximize the exposure of the nasal anatomy. All other Rhinoplasty is done entirely through the nostril, i.e. the Closed or Endonasal Approach. The only synthetic material used in the nose in our practice may be Gortex along the dorsum or profile for augmentation. Gortex or other synthetic materials are never used in the tip. We use injectable fillers at times for small imperfections i.e., LIQUID RHINOPLASTY.

A second or third nasal operation to correct a persistent or new deformity arising from a rhinoplasty by another surgeon is usually not a pleasant thought. Down time, finances and more anxiety all interact for the patient considering additional nasal surgery. However, our practice has extensive experience with Revision Rhinoplasty and we use the same approach as for a first time patient. History taking, physical examination, nasal endoscopy, prior and recent photographs and a possible CT scan may all be necessary to make an exact diagnosis to correct an aesthetic with or without airway problem. Some revisions can be simply done in our office and others may require extra anesthesia as an outpatient at Northwest Community Hospital.

Preoperative evaluation, meticulous surgery and methods to reduce swelling make the convalescence from Rhinoplasty rapid. No nasal packing is used; a small soft dressing is removed from the nostril the day after surgery, and patients usually require only Ultram® or plain Tylenol® for discomfort. Nasal splints or casts are removed at five to seven days and the nasal tip may be re-taped for three to five additional days. Our patients are seen at regular three-month intervals at no charge during the first year, and if possible, we like to see them yearly after that time. Most patients with realistic expectations undergoing Rhinoplasty find it to be a pleasant and rewarding experience. Our patients have been very pleased with our approach and their outcomes. Please see our pre- and post-op photo gallery.