ROBERT A. GUIDA M.D., P.C.

RHINOLOGY:Cosmetic and Functional Nose Surgery

www.drguida.com

My mission is to truly understand what my patients’ goals are and then

educate them aboutrealistic and optimal

treatment options.

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Dr. Robert A. Guida has repeatedly been listed in the Castle Connolly Guide of Best Doctors recognizing him as one of “the best doctors in New York,” New York Magazine’s feature on top “Beauty Doctors”in New York City, and in New York Magazine’s Best Doctor Issue. He has been practicing rhinology (the study of the nose) and facial plastic and reconstructive surgery in New York since 1990.

Dr. Guida has unique and extensive training in both functional and cosmetic nose surgery. He is double board certified in Facial Plastic and Reconstructive Surgery as well as Otolaryngology-Head and Neck Surgery. Because of his unique training, Dr. Guida is highly skilled in surgical treatment of all aspects of nasal sinus disease, functional nasal problems, surgery for nasal obstruction, cosmetic rhinoplasty, repairing broken noses, and complex revision rhinoplasty.

ABOUT DR. GUIDA

DEVIATED SEPTUM

INTERESTING FACT:

More than 37 million Americans suffer from at least one episode of acute sinusitis each year.

Above is a photograph of real time image guided surgery, using a patient’s CT scan synchronized with live video.

TREATMENT OF SINUSITIS

Endoscopic sinus surgery, computerized image guided surgery, and high-resolution CT scans have revolutionized the surgical treatment of sinus disease. Using a small rigid endoscope connected to a large video monitor, this surgery can be done under direct, magnified vision yielding specific and positive results. New image-guided technology allows a CT scan to be used as a real time “road map” during the procedure, allowing for precise accuracy during the oper-ation. The operation can be done under twilight or general anesthe-sia and there generally is no nasal packing postoperatively. Patients typically require several days off of work after this procedure for recovery.

Chronic sinusitis is a functional problem of the nose, which affects a large portion of the population. Often times it is also related to allergic rhinitis. Typically, people with chronic sinusitis have recurrent sinus infections and head colds several times a year over a few years. Antibiotic treatment will typically improve the situation initially. However, shortly after stopping the antibiotic therapy the infection will recur. Symptoms include headaches, facial pain, nasal congestion, nasal drainage, postnasal drip, and occasional visual changes. Prior to the use of antibiotics, sinusitis was life threatening potentially causing meningitis and even death.

“I cannot breathe through my nose. Can that be fixed at the same time

Frequently, cosmetic nasal surgery is done simultaneously with functional nasal surgery and sinus surgery. The most common functional complaints patients have regarding their nose is that they cannot breathe through it or that they suffer from frequent sinus infections. Surgical problems causing nasal obstruction that are easily corrected related to the nose include a deviated and/or fractured nasal septum, nasal polyps, a broken nose, chronic sinus infections, or enlarged turbinates. Dr. Guida can determine the cause of the nasal obstruction by both a physical exam as well as a CT scan of the nose and paranasal sinuses. This will give Dr. Guida detailed information and allow him to provide you with a clear assessment of your options and chances for improving your nasal obstruction.

that I am having surgery to make my nose look better?”

DEVIATED NASAL SEPTUM

INFERIOR TURBINATEHYPERTROPHY

TREATMENT OF NASAL OBSTRUCTION

Fixing a deviated nasal septum involves one small incision inside the nose. Fixing this problem by itself generally does not cause any external bruising and there is no need for a nasal splint following the operation. Dr. Guida rarely packs the nose following the operation, as he uses dissolvable sutures to hold the structures in place afterwards. Typically, the patient can breathe well initially in the recovery room, but within several hours after the operation, the nasal lining swells and it could take approximately 1-3 weeks for the swelling to go away. Frequently, a deviated nasal septum can affect the external shape. Therefore, it is often straightened during cosmetic rhinoplastly.

BEFORE AFTERBEFORE AFTER

TREATMENT OF NASAL OBSTRUCTION

REVISION RHINOPLASTYRevision rhinoplasty is a complex operation that must always be performed with much thought and care. Dr. Guida has successfully performed revision rhinoplasty surgery on a large number of patients from around the world. Often, patients seeking revision rhinoplasty have a combination of cosmetic and functional concerns, requiring a surgeon highly skilled in both types of surgery. Dr. Guida’s unique double board certification in both Facial Plastic Surgery as well as Otolar-yngology – Head and Neck Surgery, as well as over twenty years of experience, makes him extremely qualified and proficient at performing revision rhinoplasty surgery. Cosmetically, there often is an unnatural appearance to the nose, ranging from tip asymmetry to a “scooped-out” nasal bridge. There may be nasal obstruc-tion from a deviated nasal septum, open roof deformity, chronic sinusitis, or a septal perforation. Dr. Guida can assess these issues and determine the most appropriate treatment plan for a successful outcome.

BEFORE AFTERBEFORE AFTER

COSMETIC NOSE SURGERY

Endoscopic sinus surgery, computerized image guided surgery, and high-resolution CT scans have revolutionized the surgical treatment of sinus disease. Using a small rigid endoscope connected to a large video monitor, this surgery can be done under direct, magnified vision yielding specific and positive results. New image-guided technology allows a CT scan to be used as a real time “road map” during the procedure, allowing for precise accuracy during the oper-ation. The operation can be done under twilight or general anesthe-sia and there generally is no nasal packing postoperatively. Patients typically require several days off of work after this procedure for recovery.

Rhinoplasty, commonly referred to as a “nose job”, is an operation that cosmetically improves the appearance of the nose. Cosmetic problems of the nose can be either genetic or acquired, perhaps due to an accident, resulting in a fractured nose. The most common cosmetic problems encountered are noses that are too large relative to the rest of the facial features, noses with prominent bumps on the bridge, noses with wide nasal bridge, noses that are very crooked due to a fractured nasal bones, or a congenital deviated nasal septum.

Because of the individualized concerns each patient has with rhino-plasty surgery, Dr. Guida prefers using digital computer imaging to analyze the patients facial and nasal proportions prior to surgery. Altering the shape of the nost on the computer allows for a more interactive discussion between Dr. Guida and the poatient in terms of final outcome of surgery.

Can I get an idea of what my new nose will look like before actually having surgery?

This patient had a deviated septum, a hanging columella and a broken nose repaired. Dr. Guida’s work provided a more

BEFORE

AFTER

ETHNIC RHINOPLASTY

There are non-surgical approaches to cosmetically improving one’s nose that are proven to be highly successful. In appropriately selected cases, Dr. Guida can use injectable fillers to create both permanent (Silikon-1000) and temporary (Radiesse. Juvaderm, and Restylane) corrections. Temporary corrections may last as long as several months to a year with no need for surgery.

These procedures can resolve imperfections in the nasal bridge, tip, and nostrils in as little as one office visit, requiring no anesthesia and having no down time. Injectables can camouflage a small bump, straighten a crooked appearance, bring balance to asymmetry, widen a pinched tip, and lower excessively high nostrils. An experienced nasal surgeon is essential in obtaining optimal results. Dr. Guida has a proven success rate for this type of procedure.

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NON-SURGICAL RHINOPLASTY

Over the past several decades ethnic rhinoplasty, performed on Hispanic, Asian, African Amer-ican, and Middle Eastern patients, has become increasingly commonplace. This type of surgery focuses on maintaining balance between cosmetic alterations and ethnic characteristics to achieve a natural and cosmetically attractive appearance. Commonly, patients seek more refine-ment of a bulbous nasal tip and narrow a wide nasal base, nostrils, and nasal bridge. Dr. Guida has succes fully operated on hundreds of patients from around the world for these conditions and is highly skilled at this type of surgery. With preoperative computer imaging and carefully listening to patients concerns, he can help the patient reach their cosmetic and functional goals.

BEFORE AFTER BEFORE AFTER

SKIN CANCER OR TRAUMA

Over a million new cases of skin cancer are diagnosed and treated each year in the United States. 80% of these cancers are on the face or head and neck region. Skin cancer removal of nasal tissue requires careful cosmetic reconstruction to achieve minimal deformity and a natural aesthetic result. Dr. Guida has extensive experience in facial and nasal reconstruction following excision of skin cancers or as a result of facial trauma. He has published numerous articles and lectured extensively on the various types of facial reconstructive techniques. Often after the cancer excision, the result is a significant soft tissue and structural defects. Dr. Guida will choose the most appropriate technique, from skin grafting to simple or complex facial flaps, to most appropriately reconstruct these defects.

OTHER NASAL SURGERY

For all further inquires please contact our office to schedule a consultation with Dr. Guida.

CONTACT INFORMATION

Robert A. Guida, M.D., P.C. 1175 Park Avenue, Suite 1-B

New York, NY 10128

Appointments: 212-871-0900 Office Fax: 212-871-0909 Web: www.drguida.com Email: info@drguida.com