Many challenging complex secondary rhinoplasty cases in Newport Beach are referred to Dr. Daniel by his colleagues. These cases range from complex congenital deformities (cleft lip noses, Binder’s syndrome), to post traumatic crooked and collapsed noses (saddle noses, coaine), to tertiaries (multiple failed rhinoplasties) which can be corrected with our Reconstruction Rhinoplasty services in Newport Beach. Fortunately, many of these complex cases require sophisticated surgical techniques which Dr. Daniel developed. In 1996, Dr. Daniel did a retrospective evaluation of nasal dorsal reconstruction comparing the use of cranial, iliac, and rib grafts. It was evident that rib grafts were clearly superior to the then popular cranial bone graft as regards ease of harvest, amount of tissue and flexibility. However, most solid rib grafts had a tendency to warp or become visible with time. Therefore, in 2004, Dr. Daniel published his technique of “diced cartilage wrapped in fascia” which gave a more natural nasal bridge with less risks as compared to solid rib grafts. Then in 2006, he introduced the concept of “composite reconstruction” for rebuilding severe collapsed saddle noses. This approach allows the foundation of the nose to be stabilized with solid rib grafts and then for the tip and bridge to be reconstructed with soft concealer grafts – thus the deep foundation stabilizes the nose while the aesthetic layer achieves the desired shape.
Recently, Dr. Daniel has been seeing a large number of patients who have had nasal surgery by two or more other surgeons. These cases can be very challenging as the structure of the nose may be compromised and the septum previously harvested. At a the Annual Meeting of the American Society of Aesthetic Plastic Surgeons in May, 2015, Dr. Daniel discussed his approach to these patients. He stated that it was important to understand the patient’s goals, both at the present time and before they had any nasal surgery. Most patients still want the smaller cuter nose they originally sought and are frustrated that they have not been able to achieve it. Obviously, there will be tissue and technical limitations as to what can be achieved. However, the ultimate goal is aesthetic reconstructive rhinoplasty. Dr. Daniel coined this term to emphasize that the deeper structural tissues must be reconstructed whereas the shape of the nose must be aesthetic – the nose must be structurally sound, but has to be attractive. A structurally sound nose that looks “reconstructed’ is not a success.
Patients seeking solutions to their complex secondary cases will benefit from Dr. Daniel’s expertise and emphasis on designing an individualized operative plan for each patient. Frequently, secondary patients find themselves confused as to their options as each surgeon they see recommends their own favorite operation. Some will favor a limited approach using a closed technique while others suggest a complex reconstruction using a large number of rib grafts. In contrast, Dr. Daniel will take the time to analyze your deformity and explain why he has selected the specific operation for your specific deformity based on his extensive experience with a wide range of techniques. The goal is to fit the operation to the patient not the patient to the operation.
Secondary rhinoplasty is truly the most challenging of all nasal surgery and the surgeon must be experienced with a large number of diverse techniques. His experience with ethnic rhinoplasty in Newport beach makes him a top choice in the field, furthermore proving his practice is based on client happiness. Fortunately, patients needing secondary rhinoplasty surgery in Newport Beach come to Dr. Daniel because of his expertise and his extensive experience with the operative techniques which he has developed for solving the most complex cases.