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Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

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Revision Rhinoplasty Specialist

Revision Rhinoplasty Specialist reports on a comprehensive study

New York, NY:

Revision rhinoplasty can be a frustrating situation for the patient, which is why it is even more important for surgeons to understand why people seek revision surgery. In October, Drs. Yu and Kim, residents from New York Presbyterian Hospital presented a study at the annual meeting of the American Academy of Facial Plastic and Reconstructive Surgery on revision rhinoplasty that we conducted on my patients. Our goal was to present why patients seek revision rhinoplasty. Prior articles in the medical literature all discussed these findings from the doctor’s point of view. There are many scholarly articles on this subject, but they all looked at what the doctor thought was important. We decided to survey 104 consecutive patients seeking revision rhinoplasty to see what their concerns were, before I chimed in with my opinions. This unique study is to parallel trends in modern medicine and to focus on the patient’s point of view.

104 consecutive patients filled out a comprehensive questionnaire that asked questions about their noses from top to bottom and functional (breathing) complaints. They were also asked to identify their top three reasons for seeking revision rhinoplasty. The most frequently cited concerns were tip asymmetry, crooked middle third of the nose and irregular upper (bony) third of the nose. The three top concerns differed a little with difficulty breathing cited as the second largest concern with tip asymmetry still first and crooked nose third.

Breathing problems was a very common finding. 62% of patients reported nasal obstruction and 71% were found by the surgeon (me) to have blockage of the nose.

At the end of the survey, we asked why patients didn’t go back to their original surgeon and 57% indicated that since the surgery was not successful, they would not go back. 23% reported that their original surgeon was not receptive to their concerns. For the other 20%, surgery was either too long ago, their doctor is no longer in practice or they moved. Therefore, surgeons must be aware that good communication and understanding patient concerns are of the utmost importance in addressing revision rhinoplasty.  Steven J. Pearlman, MD, FACS 

Revision Rhinoplasty

Revision rhinoplasty is my specialty. I am often called on to reshape noses that are “pinched” or deformed from previous surgery or traumatic injury. Many times I will also revise noses that are too narrow or collapsed from trauma or just plain old do not function well.

My background is in Ear, Nose and Throat surgery, so I feel I am adept in creating a more functional and sculpted nose for my patients. To quote a traditional architectural theme, in terms of the nose, “form follows function.” It is my passion to restore this function.
Most of the functional and breathing problems I encounter deal with blockages of the nose from conditions like a deviated septum and sinusitis. I can address both of these issues at the same time.

I perform a thorough exam of the inside of the nose during your consultation, using a specialized headlight for viewing the nose. Sometimes I may need to use nasal endoscopic equipment to get a better view.

Other nasal procedures that I perform are septoplasty, reconstruction of the skin and structures of the nose after removal of skin cancers and correction of septal perforations.

If you have any questions on Rhinoplasty, please feel free to contact my office for a consultation. For more information on Rhinoplasty or other cosmetic surgery procedures, please visit my web site. Here you will find detailed information and before and after photos.

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