Monday, August 24, 2015

Can a Facial Plastic Surgeon perform Sinus Surgery?

Rhinoplasty or nose job surgery is commonly performed to change the shape of the nose. Many of these patients may have a deviated septum or trouble breathing due to turbinate enlargement. In addition, some of these patients have chronic sinus issues with recurrent sinusitis or sinus infections.

A facial plastic surgeon is one who has undergone extensive ear, nose, and throat surgery training in addition to a facial plastic surgery fellowship. He or she should have knowledge and experience in sinus surgery and be capable to address your sinuses (if they require surgery) at the time of your rhinoplasty.

As a rule of thumb, I am comfortable performing sinus surgery at the time of rhinoplasty as long as the sinus aspect of the case is fairly straightforward. If this is revision sinus surgery, significant polyps, or fungal sinusitis, I would recommend a sinus specialist and not a facial plastic surgeon for your surgery.

Dr. Funk is a nose doctor in Houston, Texas.

Tuesday, August 18, 2015

Why is revision rhinoplasty more difficult?

Rhinoplasty alone is a complex operation that requires knowledge of the nasal anatomy, understanding of nasal aesthetics, and the wound healing process of the nose. Revision rhinoplasty is an even more complex surgery for multiple reasons. Anytime rhinoplasty is performed, a layer of scar tissue is left between the nasal skin and cartilage. Getting through this scar tissue during revision rhinoplasty to identify the underlying residual cartilage is difficult. Sometimes, this cartilage can be weak, flimsy, or non-existent. Septal cartilage may not be available for grafting purposes during revision rhinoplasty requiring the surgeon to utilize ear cartilage or possible rib cartilage.

The wound healing process can also be more unpredictable for revision rhinoplasty as there will now be another layer of scar tissue on top of the old layer of scar tissue. If multiple revisions have been performed, more scar tissue layers will be left behind. In addition, revision rhinoplasty swelling will typically take longer to resolve compared with primary rhinoplasty.

Dr. Funk is a rhinoplasty expert in Houston, TX.

Wednesday, August 12, 2015

Best Candidate for Rhinoplasty

Rhinoplasty or nose job surgery is not for everyone. A qualified rhinoplasty surgeon will evaluate you to assess if you are a good candidate for rhinoplasty. The best rhinoplasty candidate is a patient who has realistic expectations. The best rhinoplasty surgeon should be able to make almost every nose (at least primary rhinoplasty nose) look better. What a patient has to realize is that plastic surgery and sculpting a statue or sculpture are a little different. It is true that with nose job surgery you are sculpting the nose and creating a more refined product. However, unlike with a statue, there is a whole wound healing process involved after surgery that is out of the hands of the surgeon. There are certain things that a surgeon can do to improve the wound healing process and minimize swelling to ultimately get a better rhinoplasty result. Although I seek perfection with every surgery I perform, I know that ultimately, I cannot control the wound healing process and as long as the patient understands this, they are the best candidate for rhinoplasty.

Dr. Funk is a rhinoplasty expert in Houston, TX.

Monday, August 3, 2015

Is rhinoplasty covered by health insurance

Rhinoplasty or nose job surgery is typically a surgery described to change the outside appearance of the nose. There is such a thing called “functional rhinoplasty”, where the same open rhinoplasty approach for cosmetic changes is taken, but only functional ones are made. This type of surgery is reserved for a severely deviated nasal septum or valve collapse. Sometimes the entire deviated or caudal septum is removed and a new septum is built with complex septoplasty techniques. Spreader or batten grafts may be used to support the valve. If you are considering cosmetic changes to your nose and will have an open rhinoplasty anyhow for functional issues, that is typically a good time to make concomitant cosmetic changes.

Health insurance (depending on the carrier and type of coverage) typically will cover functional rhinoplasty. But once cosmetic changes are considered such as taking down a hump, straightening a nose, rotating the tip, or refining a bulbous tip, insurance will not pay for these changes.

Dr. Funk is a top rhinoplasty surgeon in Houston, TX.

Eyelid Surgery Cost

The cost of eyelid surgery or blepharoplasty typically depends on a few factors. Surgeon’s fees vary and the complexity of the eyelids will typically be related to the price.

Upper eyelid surgery is typically straightforward unless there is ptosis or a lazy eye. In that case, a ptosis repair may be necessary which may increase cost. Revision or repeat upper eyelid blepharoplasty may also be more costly due to increased scar tissue and complexity of the eyelid.

Lower eyelid blepharoplasty is a more involved surgery than upper which requires more skill and experience. There is less margin for error with lower blepharoplasty. Lax lower eyelids may require canthopexy or canthoplasty in addition to the lower eyelid surgery. Transconjunctival or skin flap approaches to the lower eyelid may cause costs to vary. Fat repositioning is more complex than simple fat removal and will therefore increase the price of lower blepharoplasty. All these factors are likely taken into account when factoring the cost for lower eyelid surgery.

Dr. Funk is a board certified facial plastic surgeon specializing in eyelid surgery in Houston, TX.