Riverside Facial Plastic Surgery and Sinus Center

slideshow
ch7 hiccup video
Celebrity Plastic Surgery by Frank J. Scaccia, M.D., F.A.C.S.
sinuplasty video

laser surgeryWelcome to Riverside's home page. As medical director of the facility, Dr. Frank Scaccia is a uniquely qualified Dual Board Certified Facial Plastic Surgeon and Otolaryngologist who specializes in cosmetic surgery, plastic surgery, rhinoplasty, facelift and treatment of sinus/nasal disorders. After a unanimous vote by his peers, Dr. Scaccia was appointed for 2012 as the Chairman and Section Chief for the departments of Ear, Nose and Throat, and Head & Neck Surgery at Meridian Health's Riverview Medical Center in Red Bank, NJ. Riverview is one of the busiest and most respected hospitals in the region being a 5 time winner of The J.D. Power and Associates Award. His list of honors in plastic surgery includes the Jack Anderson Award which he won in 1995 after receiving the highest score in the United States on the certifying exam given by the American Board of Facial Plastic & Reconstructive Surgery. In addition, his surgical abilities have been featured in Time, Newsweek, Channel 7 "Eyewitness News," and most recently this past June on the "Anderson Cooper Show" where a TV personality was commenting to Mr. Cooper how much she likes her new nose that Dr. Scaccia operated on for her and that he is an "amazing doctor." He has also contributed to the medical literature with publications in textbook and journals. Dr. Scaccia was one of the first to publish in a textbook a technique to perform simultaneous rhinoplasty and sinus surgery. Follow this link for a copy of this interesting book chapter.
MM More recently, Dr. Scaccia has been named as one of New Jersey's leading cosmetic surgeons in a special article on "Top Beauty Docs" by NJ Savvy Living Magazine magazine in the February 2006 through 2009 editions. Furthermore, he was cited as one of only seven cosmetic surgeons in New Jersey that was specifically recognized for his rhinoplasty nose skills. The criteria for selection of this honor was based on Castle Connolly's physician lead research team who uses a vigorous screening process to survey physicians and administrators at leading hospitals for recommendations of highly skilled, exceptional doctors in the field of cosmetic plastic surgery. In addition Dr. Scaccia has also earned the prestigious recognition of being listed in the 2006 to 2010 editions of "The Guide to America's Top Physicians," the 2006 through 2013 editions of "Top Doctors: New York Metro Area," the 2011 listing in "US News &World Report" of Top Doctors and 2012 edition of Top Doctors: The-Star-Ledger's Inside Jersey, the Marquis' 2007 through 2012 editions of "Who'sWho in America" and most recently, has been selected for inclusion in both the 2010 and 2012 editions of "Who'sWho in Medicine and Healthcare," and the 2011 through 2012 edition of "Who'sWho in the World." Finally, Dr Scaccia has the added distinction of being included in the 2013 list of "Top Cosmetic Doctors" in the nation by Castle Connelly Medical Ltd.
MM His new office is located in the historic town of Red Bank allowing convenient access from all northern and central New Jersey sites and the New York City metropolitan area. The plastic surgery NJ and sinus center NJ includes it's own federally approved and accredited ambulatory outpatient surgical suite built to hospital safety standards and is one of the first in Monmouth County to utilize Brain Lab's Image Guided Navigational Sinus System allowing for state-of-the-art endoscopic sinus surgery.
MMRiverside has also been awarded accreditation by JCAHO (Joint Commission on Accreditation of Healthcare Organizations) the nation's leading evaluator among hospitals and other healthcare groups for quality care and patient safety. The center underwent a thorough onsite evaluation against nearly 150 standards which demonstrates our mission to provide the highest level of care possible. Your safety, comfort and privacy are our top priorities. Procedures can be performed under various levels of anesthesia (including general and twilight sleep) and will be administered by only board certified physician anesthesiologists. You will find that Dr. Scaccia's commitment to safety and excellence is exemplified throughout this web site. One benchmark is the fact that in his 20 years (residency training and private practice) as a physician (which includes thousands of surgical procedures) no medical malpractice judgments or even settlements have ever been brought against him.
MMSome of the facial plastic surgery procedures performed at the center include facelift, rhytidectomy, mini facelift, midface lift, s-lift, platelet gel facelift, weekend neck lift, eyelid rejuvenation, blepharoplasty, eyebrow lift, forehead lift, lip enhancement/rejuvenation, chin/cheek implants, liposuction, snoring and sleep apnea correction, female nasal sculpturing, rhinoplasty, male nasal sculpturing, rhinoplasty, Asian nasal surgery, Afro-American rhinoplasty, Ethnic rhinoplasty, revision/redo nasal surgery and sinus surgery.
MMBotox injections, laser surgery for tattoos, moles, pigment, spider veins, wrinkles, skin resurfacing, hair removal and scars are also available. Other plastic surgery procedures performed include ear surgery (otoplasty), split earlobe repair, AlloDerm implants, sclerotherapy and chemical peels. Gentlewaves LED Photomodulation is a new technology that we are now using to reverse photoaging and potentially speeds healing after surgery.

ch 12 news
ch 12 news
Profile
sinus treatment
sinus surgery link
photo gallery
virtual tour
procedures
accommodations
scaccia in the news
health and fitness
directions
finance
Dr. Scaccia

70 East Front St., Third Flr., Red Bank, NJ 07701 • Tel: (732) 747-5300 / Fax: (732) 747-9922

Additional Offices:


525 Route 70, Suite 3A, Brick Township, Ocean County, NJ 08723 •
Tel: (732) 262-3695
305 Seguine Avenue Suite #1 Staten Island, NY 10309 • Tel: (718) 967-2411
219 Taylors Mills Road, Manalapan, NJ 07726 • Tel: (732) 308-6000

award
allergychoices
Privacy Notice
Privacy Notice
form mail email address
new patient  
consent form  
consent form  

Content and photos are the intellectual property of Frank J. Scaccia, M.D., F.A.C.S. and Riverside Nasal & Sinus Center and may not be used or duplicated for any reason. ©2015

 

Nose Surgery ENT Allentown NJ 08501

 

The surgical management of nasal defects and deformities divides the nose into six (6) anatomic subunits: (i) the dorsum, (ii) the sidewalls (paired), (iii) the hemilobules (paired), (iv) the soft triangles (paired), (v) the alae (paired), and (vi) the columella. Surgical correction and reconstruction comprehend the entire anatomic subunit affected by the defect (wound) or deformity, thus, the entire subunit is corrected, especially when the resection (cutting) of the defect encompasses more than 50 per cent of the subunit. Aesthetically, the nose — from the nasion (the midpoint of the nasofrontal junction) to the columella-labial junction — ideally occupies one-third of the vertical dimension of the person’s face; and, from ala to ala, it ideally should occupy one-fifth of the horizontal dimension of the person’s face. Nose surgery ENT Allentown NJ 08501.

The nasofrontal angle, between the frontal bone and the nasion usually is 120 degrees; the nasofrontal angle is more acute in the male face than in the female face. The nasofacial angle, the slope of the nose relative to the plane of the face, is approximately 30–40 degrees. Thenasolabial angle, the slope between the columella and the philtrum, is approximately 90–95 degrees in the male face, and approximately 100–105 degrees in the female face. Therefore, when observing the nose in profile, the normal show of the columella (the height of the visible nasal aperture) is 2 mm; and the dorsum should be rectilinear (straight). When observed from below (worm’s-eye view), the alar base configures an isosceles triangle, with its apex at the infra-tip lobule, immediately beneath the tip of the nose. The facially proportionate projection of the nasal tip (the distance of the nose’s tip from the face) is determined with the Goode Method, wherein the projection of the nasal tip should be 55–60 per cent of the distance between the nasion (nasofrontal junction) and the tip-defining point. A columellar double break might be present, marking the transition between the intermediate crus of the lower-lateral cartilage and the medial crus.

The Goode Method determines the extension of the nose from the facial surface by comprehending the distance from the alar groove to the tip of the nose, and then relating that measurement (of nasal-tip projection) to the length of the nasal dorsum. The nasal projection measurement is obtained by delineating a right triangle with lines parting from the nasion (nasofrontal juncture) to the alar–facial–groove. Then, a second, perpendicular delineation, that traverses the tip-defining point, establishes the ratio of projection of the nasal tip; hence, the range of 0.55:1 to 0.60:1, is the ideal nasal-tip-to-nasal-length projection. Nose surgery ENT Allentown NJ 08501.

To determine the patient’s suitability for undergoing a rhinoplasty procedure, the surgeon clinically evaluates him or her with a complete medical history (anamnesis) to determine his or her physical and psychological health. The prospective patient must explain to the physician–surgeon the functional and aesthetic nasal problems that he or she suffers. The surgeon asks about the ailments’ symptoms and their duration, past surgical interventions, allergies, drugs use and drugs abuse (prescription and commercial medications), and a general medical history. Furthermore, additional to physical suitability is psychological suitability — the patient’s psychological motive for undergoing nose surgery is critical to the surgeon’s pre-operative evaluation of the patient. In the case of men, the surgeon must identify prospective patients presenting the mental traits denoted by the psychiatric acronymSIMON (single, immature, male, over-expectant, and narcissistic), which might indicate a man over-valuing the outcome of a rhinoplasty. Nose surgery ENT Allentown NJ 08501.

The complete physical examination of the rhinoplasty patient determines if he or she is physically fit to undergo and tolerate the physiologic stresses of nose surgery. The examination comprehends every existing physical problem, and a consultation with an anaesthesiologist, if warranted by the patient’s medical data. Specific facial and nasal evaluations record the patient’s skin-type, existing surgical scars, and the symmetry and asymmetry of the aesthetic nasal subunits. The external and internal nasal examination concentrates upon the anatomic thirds of the nose — upper section, middle section, lower section — specifically noting their structures; the measures of the nasal angles (at which the external nose projects from the face); and the physical characteristics of the naso-facial bony and soft tissues. The internal examination evaluates the condition of the nasal septum, the internal and external nasal valves, the turbinates, and the nasal lining, paying special attention to the structure and the form of the nasal dorsum and the tip of the nose.

Furthermore, when warranted, specific tests — the mirror test, vasoconstriction examinations, and the Cottle maneuver — are included to the pre-operative evaluation of the prospective rhinoplasty patient. Established by Maurice H. Cottle (1898–1981), the Cottle maneuver is a principal diagnostic technique for detecting an internal nasal-valve disorder; whilst the patient gently inspires, the surgeon laterally pulls the patient’s cheek, thereby simulating the widening of the cross-sectional area of the corresponding internal nasal valve. If the maneuver notably facilitates the patient’s inspiration, that result is a positive Cottle sign — which generally indicates an airflow-correction to be surgically effected with an installed spreader-graft. Said correction will improve the internal angle of the nasal valve and thus allow unobstructed breathing. Nonetheless, the Cottle maneuver occasionally yields a false-positive Cottle sign, usually observed in the patient afflicted with alar collapse, and in the patient with a scarred nasal-valve region. Nose surgery ENT Allentown NJ 08501.

The plastic surgical correction of congenital and acquired abnormalities of the nose restores functional and aesthetic properties by the surgeon’s manipulations of the nasal skin, the subcutaneous (underlying) cartilage-and-bone support framework, and the mucous membrane lining. Technically, the plastic surgeon’s incisional approach classifies the nasal surgery either as an open rhinoplasty or as a closed rhinoplasty procedure. In open rhinoplasty, the surgeon makes a small, irregular incision to thecolumella, the fleshy, exterior-end of the nasal septum; this columellar incision is additional to the usual set of incisions for a nasal correction. In closed rhinoplasty, the surgeon performs every procedural incision endonasally (exclusively within the nose), and does not cut the columella.

Procedural differences

Except for the columellar incision, the technical and procedural approaches of open rhinoplasty and of closed rhinoplasty are similar; yet closed rhinoplasty procedure features:

  • Reduced dissection (cutting) of the nasal tissues — no columellar incision
  • Decreased potential for the excessive reduction (cutting) of the nasal-tip support
  • Reduced post-operative edema
  • Decreased iatrogenic (inadvertent) damage to the nose, by the surgeon
  • Increased availability for effecting in situ procedural and technical changes
  • Palpation that allows the surgeon to feel the interior changes effected to the nose
  • Shorter operating room time
  • Quicker post-surgical recovery and convalescence for the patient
The "ethnic nose"

The open rhinoplasty approach affords the plastic surgeon the advantages of ease in securing the grafts (skincartilagebone) and, most important, in seeing the nasal cartilages proper, and so make the appropriate diagnosis. This procedural aspect can be especially difficult in revision surgery, and in rhinoplastic corrections of the thick-skinned “ethnic nose” of the colored man or woman. The study, Ethnic Rhinoplasty: a Universal Preoperative Classification System for the Nasal Tip (2009), reports that a nasal-tip classification system, based upon skin thickness, has been proposed to aid the surgeon in determining if an open rhinoplasty or a closed rhinoplasty shall best correct the defect or deformity afflicting the patient’s nose. Nose surgery ENT Allentown NJ 08501.

Etiology

Etiologically, the open and closed approaches to rhinoplastic correction resolve: (i) nasal pathologies (diseases intrinsic and diseases extrinsic to the nose); (ii) an unsatisfactory aesthetic appearance (disproportion); (iii) a failed primary rhinoplasty; (iv) an obstructed airway; and (v) congenital nose defects and deformities. Nose surgery ENT Allentown NJ 08501.

Congenital abnormalities
  • Cleft lip and palate in combination; cleft lip (cheiloschisis) and cleft palate (palatoschisis), individually.
  • Congenital nasal abnormalities
  • Genetically derived ethnic-nose abnormalities

Acquired abnormalities such as: