Archive for the ‘Rhinoplasty’ Category
« Older Entriesrevision rhinoplasty and preventing revision nasal surgery of the dorsum
Friday, November 11th, 2011
One of the most common causes of concern after rhinoplasty is a rough dorsum or palpable ridges. These are common after dorsal humpectomy and osteotomies, particularly in thin skinned individuals. I have been using a new product whch is a collagen matrix which acts as a very thin spacer between the bone and skin with excellent results. This product (Integra) prevents and treats dorsal irregularity and is a fantastic addition to the armamentarium of the modern Rhinoplasty surgeon.
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Cosmetic Surgery Reversal
Saturday, September 10th, 2011
It is an unfortunate reality that there are many people that are unhappy with the results of their cosmetic surgery. Often these patients have seen Cosmetic Surgeons that are not appropriately qualified or had “overseas” cosmetic surgery holidays. There are many reasons that this is not a great idea but for patients that have already had the surgery and are unhappy with the results this advice may come a little late.
Surgery that has been performed may be able to be completely or partially reversed or certainly improved. Patients seeking Facial Plastic/Cosmetic procedure reversal or revision should make an appointment to see Dr Pincock at Sydney Facial Plastics at 02 88833699 or for overseas patients +61 2 88833699
For patients seeking revision or reversal of a body procedure they should make arrangements to see Dr Tavakoli – please visit his webpage by pasting the following address in your browser http://www.drtavakoli.com.au
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Posted in Blepharoplasty, Breast and Body Cosmetic Surgery, Facelift, Otoplasty (Ear Reshaping), Rhinoplasty, Uncategorized | No Comments »
Sydney Rhinoplasty Surgeon Dr Tobias Pincock – Modern Day Revision Rhinoplasty Techniques
Saturday, September 3rd, 2011
As I have mentioned before, Revision rhinoplasty is a challenging procedure for both the patient and the surgeon. For the patient because its often an emotional experience to go through another surgical procedure when they had hoped the first procedure would yield the perfect result and also for the surgeon because a) Revision rhinoplasty is a technically demanding procedure and b) managing the patients expectations and anxiety about a second procedure.
First and foremost it is extremely important that the patient wait an appropriate time between their primary procedure and a secondary or revision rhinoplasty. It is surprising despite how many times I inform patients about the time taken for subtle swelling to settle down, many patients will ask within the first month after a rhinoplasty if the nose is still swollen – of course ! I also get many second opinions from patients who have recently undergone surgery with another surgeon and are unhappy with the results and are disbelieving of the surgeon that the nose is still swollen. It is imperative that the patient understand that the healing process takes time and although most of the swelling settles by 3 months very subtle changes continue for up to 18-24 months.
If a patient seeks a revision or secondary rhinoplasty, as always it is important to make sure patient and surgeon “are on the same page” as far as desired outcome and whether that is a realistic outcome.
common revision rhinoplasty problems and the approach to correction
- further change to nasal shape – usually the result of surgeon wanting to be conservative or patient stating they did not want a major change when in fact they did. It is important to use computer imaging here to make sure both parties are aware what the desired outcome is and whether it is achievable. in particular patients will often feel their nose is over-projected after surgery. It can take some time for the nose to settle after surgery.
- asymmetry – if it is bony it is fairly straight forward and can be approached by an endo-nasal approach. if it is tip asymmetry this is more complex and will require an external approach. tip asymmetry within the first 12 months of surgery can still be related to differential rates of tip oedema resolution. Bony asymmetry can be addressed early if obvious, tip asymmetry should be delayed till at least 12 months after initial surgery unless its clear it will not resolve
- irregularity of underlying bone – this can be a common cause for patients to seek a referral or be concerned post-operatively. it is very common after surgery for there to be irregularity at the sites of bony osteotomy. These settle with time. It only needs to be addressed in the case of osteoma formation or if the irregularity is visible
- over-resection of nose – fake appearing nasal shape – this is unfortunately still a common occurence, the nose is small, very upturned and often blocked. This is almost always the result of a closed rhinoplasty technique with over-resection of lower lateral cartilages or “cephalic trim”. This needs to be corrected via an external approach rhinoplasty with an alternate source of cartilage stock. either ear or rib cartilage. Surprisingly I do occasionally get asked to achieve this look for some patients, in this situation most people will realise its not a desirable appearance after some explanation.
- post rhinoplasty nasal obstruction – very rare when performed by an ENT trained facial plastic surgeon, and most general plastic surgeons specialising in rhinoplasty recognise the at-risk patient prior to surgery. most rhinoplasty involved making the nose smaller and this can reduce airflow in a patient with a marginal nasal airway. This can be corrected quite easily by an ENT (ear, nose and throat surgeon) and does not require an external incision.
Undergoing rhinoplasty can be an extremely positive experience. It is imperative that a patient choose their rhinoplasty surgeon wisely. Visit http://www.rhinoplastysydney.net.au or call us at Sydney Facial Plastics on 02 88833699 if in Australia or +61 288833699 from overseas for more information about making a consultation regarding rhinoplasty.
Tags: revsion rhinoplasty, Rhinoplasty, rhinoplasty expert, rhinoplasty specialist, rhinoplasty sydney, secondary rhinoplasty, sydney rhinoplasty
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nasal surgery to correct nasal obstruction
Sunday, August 14th, 2011
Anyone that has had a bad cold or flu knows how frustrating nasal obstruction can be. Human beings are obligate nasal breathers which means that breathing through the mouth is possible but not preferable which is why nasal blockage is so annoying. There are five main reasons a nose may be blocked
1) deviation of the nasal septum
2) turbinate enlargement
3) nasal mucosal lining inflammation
4) adenoidal enlargement (most commonly in children)
5) external nasal deformity (including alar and tip collapse)
It is imperative that a correct diagnosis is made for your nasal obstruction as treatment needs to be directed at the exact problem. For example. performing septal surgery on someone with bad hay fever/allergic rhinitis is a waste of time. Similarly giving nasal steroid spray to someone that has an extreme septal deviation is not going to work.
An examination of the nose must be performed initially to assess the cause of nasal obstruction. Mucosal irritation can be treated with nasal sprays, immunotherapy or UV light therapy (rhinolight). Anatomical abnormalities such as adenoid enlargement, deviated nasal septum, turbinate hypertrophy pr external nasal issues are all treated surgically.
I often see desperate patients who have had 3 operations on their septum that clearly have unaddressed mucosal disease or an external nasal deformity such as alar collapse that is easily rectified.
I am dedicated to correctly diagnosing the cause of a patients nasal obstruction and treating it appropriately. Please call 02 88835368 to book a consultation for nasal obstruction. For any cosmetic disorders of the nose please call 02 88833699 or visit htttp://www.sydneyrhinoplastyexpert.com
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Dorsal Hump surgery – Rhinoplasty Surgery in Sydney
Thursday, July 7th, 2011
The dorsal hump or “high nasal bridge” is the most common developmental deformity that brings people to seek rhinoplasty. Many times potential rhinoplasty patients feel that it is relatively easy to just “shave it off”. Removal of a dorsal hump is actually quite easy to do, but making it look natural and smooth is the challenge. This is particularly the case in thin skinned individuals where any irregularity can be seen through the often paper thin skin that covers the dorsal hump.
Dorsal humps can be either bony or cartilaginous but most often are a combination of both. My technique is to expose the hump completely and then take it down by shaving it about 1/2 mm at a time. I think this a good way to make sure not too much is removed which results in a very artificial overdone appearance.
So what is the ideal dorsum?, well it differs for everyone and is a combination of several factors including skin type, facial bone structure, cultural background and personal preference. This is where computer imaging is very beneficial as many patients think they want a certain profile but realise it does not suit them after seeing the imaged profile. Personally I think a straight or very slightly convex dorsum is desirable in a male and a straight or very gentle concavity is desirable in a female.
It is very important to identify a low nasal takeoff or nasal radix on initial assessment as this can lead to over aggressive dorsal humpectomy if not recognised. In these cases a small radix graft with crushed cartilage and a conservative rasping of the dorsal hump yields a very natural result. This is especially true in asian rhinoplasty where the nasal take off point is often very shallow.
To discuss the possibility of dorsal hump surgery you should see a trained rhinoplasty surgeon, which is either an ENT surgeon with specialised training in facial plastic surgery or a general plastic surgeon with an interest in facial surgery. Make sure your surgeon has an FRACS qualification.
please visit http://www.rhinoplastysydney.net.au for more detailed information on rhinoplasty.
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Dr Pincock expands practice to Wollongong and the South Coast
Saturday, June 25th, 2011
Dr Pincock has always travelled to Wollongong in the Illawarra to consult patients in a combined clinic with Dr Stuart Mackay of Illawarra ENT and Head and Neck. He has recently extended his commitment to the Illawarra region by seeing patients at least once per fortnight and operating on patients at either one of two excellent medical institutions in the area, either Wollongong day surgery or Figtree Private Hospital. For more information on making an appointment to see Dr Pincock in the Illawarra region please paste the following address in your browser: http://www.illawarraent.com.au/ or visit www.illawarraent.com.au
Appointments can be made by calling Sydney Facial Plastics on 02 88833699 or calling Illawarra ENT, Head and Neck on 02 42261055
Dr Pincock has a pure facial plastic and reconstructive practice in the Illawarra and therefore only see’s patients for the following issues there
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Posted in Blepharoplasty, Botox, Facelift, Facial Implants, Fillers, Functional Rhinoplasty, Necklift, Otoplasty (Ear Reshaping), Rhinoplasty, Skin resurfacing | No Comments »
Diced or Crushed Cartilage graft in Revision Rhinoplasty
Friday, June 3rd, 2011
In Revision or secondary rhinoplasty, often the end result is a harsh look with significant asymmetry, this can be particularly evident in thin skinned individuals. Crushed or diced cartilage can be used to soften the nose and create a more natural look, asymmetry can also be addressed. It can also be used to gain projection, and achieve up or down rotation. It is particularly advantageous in the nasal tip.
Dr Pincock uses this technique in all rhinoplasty operations but it is a critical manoeuvre during revision or secondary rhinoplasty. Because he is a fully trained ENT (Ear, Nose and Throat) Surgeon his ability to locate and remove cartilage from the inside of the nose and ear is very useful for revision rhinoplasty.
For more information on revision Rhinoplasty please visit www.rhinoplastysydney.net.au
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Rhinoplasty Specialist in Sydney
Sunday, May 29th, 2011
Rhinoplasty is an operation that should only be performed by a rhinoplasty expert or rhinoplasty specialist. Most ENT (ear, nose and throat) surgeons and Plastic surgeons have little or no experience with cosmetic rhinoplasty in Sydney due to the training schemes being largely based on the public hospital system. ENT trainee’s will get exposure to rhinoplasty procedures through the septorhinoplasty procedure for nasal breathing as cosmesis is corrected as well and rotation through private hospitals and plastic trainees will get exposure through de-gloving injuries and rotation through private hospital attachments. Therefore when seeking a rhinoplasty in Australia or Sydney you simply have to look past the doctor’s basic qualifications. FRACS is a start which means they are a qualified surgeon and being a member of ASOHNS or ASPS is better meaning they are an ENT surgeon or a plastic surgeon. However this is still not enough, your surgeon should be a facial plastic surgeon or a plastic surgeon with specialty training in rhinoplasty.
If you have any sinus disease or nasal obstruction you simply have to see an ENT surgeon with Facial Plastic Training.
Dr Pincock is a rhinoplasty expert and has dedicated a large part of his training to be a rhinoplasty specialist in Sydney. He completed a coveted fellowship in the US in facial plastic surgery and sat the US board exams in Facial Plastic Surgery, gaining him acceptance into the International Federation of Facial Plastic Surgeons, this Federation currently at the time of this post has only 3 Australian members. Dr Pincock is simply higher trained in this procedure than most other surgeons offering this procedure and that means that as a specialist in rhinoplasty he is able to offer a more natural, more aesthetically pleasing nose than most other surgeons and is able to address your nasal obstruction and sinus disease simultaneously.
For more info please cut and paste this address in your browser: www.rhinoplastysydney.net.au or visit http://www.sydneyfacialplastics.com.au/cosmetic.html#rhinoplasty
External Rinoplasty in Male 3 weeks after
External Rinoplasty in Female 8 weeks after Surgery
Dr Pincock is an expert in rhinoplasty and rhinoplasty Specialist. to make an appointment please call 02 88833699.
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What is a nosejob, nose job, rhinoplasty anyway ?
Friday, May 27th, 2011
what some people refer to as a nosejob or nose job is more correctly called a rhinoplasty.
A rhinoplasty is to change the underlying structure and therefore the shape and function of the nose.
A rhinoplasty in sydney is performed by a surgeon who is qualified to perform rhinoplasty procedures, this is usually an ear, nose and throat surgeon with appropriate facial plastic training or a plastic surgeon with a particular interest in rhinoplasty. The cost of rhinoplasty in Sydney depends on the complexity of the nasal procedure and whether it is a complete reconstructive rhinoplasty, revision or secondary rhinoplasty or primary rhinoplasty.
Rhinoplasty may be cosmetic or functional.
Rhinoplasty is also called nasal reshaping, nasal sculpting or nasal cosmetic surgery
http://www.sydneyfacialplastics.com.au/cosmetic.html#rhinoplasty
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Asian Rhinoplasty in Sydney
Saturday, October 23rd, 2010
Asian patients seeking rhinoplasty usually have a completely different set of goals to Caucasian patients. Caucasian rhinoplasty usually entails a reduction of the nasal size with reshaping while preserving adequate nasal function. Asian rhinoplasty on the other hand is usually an augmentation procedure.
When augmenting any part of the body the ideal material is obviously material that is compatible with the body. Traditionally Asian rhinoplasty have used artificial implants to augment the nasal dorsum and increase tip projection.
Dr Pincock uses the latest facial surgical techniques to augment the Asian nose without using silicone implants, wherever possible he will use the patients own cartilage and biocompatible implants if necessary.
for more information on asian rhinoplasty click here
http://emedicine.medscape.com/article/1293426-overview
for more information on having a rhinoplasty click here
www.sydneyfacialplastics.com.au/cosmetic.html#rhinoplasty
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