Our Rhinoplasty Philosophy
If you are reading this page about rhinoplasty on our website, I have no doubt that you have read many other similar pages, and that they are all blending together in your mind. Perhaps they all promote the “artistry” and high status of the surgeon in question? These pages make it very difficult for the reader to discriminate quality rhinoplasty abilities amongst surgeons.
Here, however, our aim is to provide the discriminating reader with logical and substantial explanations of specific advantages of a more unique perspective. Those individuals seeking generic or conventional techniques or explanations will be best served elsewhere.
Dr. Stupak’s Perspective on Rhinoplasty
First, let’s begin with my unique perspective on rhinoplasty. Most rhinoplasty surgeons in our region are in private practice, primarily performing surgery as a business. In contrast, I am an Associate Professor at the Albert Einstein College of Medicine in New York, where I am chiefly engaged in teaching rhinoplasty, assessing rhinoplasty outcomes, and developing cutting-edge novel rhinoplasty techniques. With a team of researchers that includes biomechanical engineers, sleep physicians, radiologists, pathologists and multiple head and neck surgery residents, I lead many projects that are on-going, and have resulted in major publications and advances. Our publication list with scientific abstracts are found at here.
The research team that I am fortunate enough to work with both challenges me, but is also one of the most rewarding parts of my professional life. The techniques that we develop, for both diagnosis and surgical therapy are not advanced for the sake of novelty, but are designed to address flaws in the current techniques and understanding. Thus, with appropriate study and testing, these advances are what translates into superior rhinoplasty techniques than are generally available. Essentially, these advances allow us to re-engineer your nose to a better shape, position, and size without the widespread excessive grafting techniques. I will explain the specifics of these new understandings below.
Why Do People Want Rhinoplasty?
So, let’s begin with the problems that causes most people in may practice to seek rhinoplasty in the first place. The most common problems are bent or deviated noses, as well as over-sized noses with a “bump”, or a tip that points too far downward. While frequently trauma can play a role in this problem, the vast majority of these cases are due to normal facial growth!
Recently, our team at the Albert Einstein College of Medicine performed a radiologic investigation into the origin of over-sized noses and septal deviation. Instead of what is conventionally believed that nasal-septal cartilage is intrinsically overgrown and deviated, the authors found that the nasal-septal cartilage is relatively the same size amongst individuals, but that the bony nasal opening in the midface (or maxilla) is too small for the cartilage in pathologic cases. This small bony “chamber” causes the cartilage to extrude externally creating a dorsal hump (or bump), and downward into the lip creating distortion known as the “tension nose deformity”.
Internally, the septum buckles and bends creating the commonly seen “septal deviation”. This new understanding gives us a new perspective to address these common problems that normally manifest as nasal breathing, aesthetic and sleep disorders: Instead of the conventional technique of attempting to remove the most deviated portions, and trying to use grafts to overwhelm the forces of deviation, surgeons can shorten the nose from the bridge (dorsum) and lip (caudal end), and the re-sized cartilage now matches the midface opening, and the elastic cartilage literally springs back to the midline. The article is scheduled to be published in the February 2018 edition of the renowned journal Plastic and Reconstructive Surgery, and features a video of the new surgical technique. See this page for more detailed information. You can also see our blog for another explanation of nasal shortenting.