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

 

NYC Rhinoplasty Allentown NJ 08501

 

In plastic surgical praxis, the term primary rhinoplasty denotes an initial (first-time) reconstructive, functional, or aesthetic corrective procedure. The term secondary rhinoplasty denotes the revision of a failed rhinoplasty, an occurrence in 5–20 per cent of rhinoplasty operations, hence a revision rhinoplasty. The corrections usual to secondary rhinoplasty include the cosmetic reshaping of the nose because of an unaddressed nasal fracture; a defective tip of the nose, i.e. pinched (too narrow), hooked (parrot beak), or flattened (pug nose); and the restoration of clear airways. Although most revision rhinoplasty procedures are “open approach”, such a correction is more technically complicated, usually because the nasal support structures either were deformed or destroyed in the primary rhinoplasty; thus the surgeon must re-create the nasal support with cartilage grafts harvested either from the ear (auricular cartilage graft) or from the rib cage (costal cartilage graft). NYC rhinoplasty Allentown NJ 08501.

Nasal reconstruction

In reconstructive rhinoplasty, the defects and deformities that the plastic surgeon encounters, and must restore to normal function, form, and appearance include broken and displaced nasal bones; disrupted and displaced nasal cartilages; a collapsed bridge of the nose; congenital defecttrauma (bluntpenetratingblast), autoimmune disordercancer, intranasal drug-abuse damages, and failed primary rhinoplasty outcomes. Rhinoplasty reduces bony humps, and re-aligns the nasal bones after they are cut (dissected, resected). When cartilage is disrupted, suturing for re-suspension (structural support), or the use of cartilage grafts to camouflage a depression allow the re-establishment of the normal nasal contour of the nose for the patient. When the bridge of the nose is collapsed, rib-cartilage, ear-cartilage, or cranial-bone grafts can be used to restore its anatomic integrity, and thus the aesthetic continuity of the nose. For augmenting the nasal dorsum, autologous cartilage and bone grafts are preferred to (artificial) prostheses, because of the reduced incidence of histologic rejection and medical complications. NYC rhinoplasty Allentown NJ 08501.

Surgical anatomy for nasal reconstruction

The human nose is a sensory organ that is structurally composed of three types of tissue: (i) an osseo-cartilaginous support framework (nasal skeleton), (ii) a mucous membrane lining, and (iii) an external skin. The anatomic topography of the human nose is a graceful blend of convexities, curves, and depressions, the contours of which show the underlying shape of the nasal skeleton. Hence, these anatomic characteristics permit dividing the nose into nasal subunits: (i) the midline (ii) the nose-tip, (iii) the dorsum, (iv) the soft triangles, (v) the alar lobules, and (vi) the lateral walls. Surgically, the borders of the nasal subunits are ideal locations for the scars, whereby is produced a superior aesthetic outcome, a corrected nose with corresponding skin colors and skin textures. NYC rhinoplasty Allentown NJ 08501.

Nasal skeleton

Therefore, the successful rhinoplastic outcome depends entirely upon the respective maintenance or restoration of the anatomic integrity of the nasal skeleton, which comprises (a) the nasal bones and the ascending processes of the maxilla in the upper third; (b) the paired upper-lateral cartilages in the middle third; and (c) the lower-lateral, alar cartilages in the lower third. Hence, managing the surgical reconstruction of a damaged, defective, or deformed nose, requires that the plastic surgeon manipulate three (3) anatomic layers:

  1. the osseo-cartilagenous framework — The upper lateral cartilages that are tightly attached to the (rear) caudal edge of thenasal bones and the nasal septum; said attachment suspends them above the nasal cavity. The paired alar cartilages configure a tripod-shaped union that supports the lower third of the nose. The paired medial crura conform the central-leg of the tripod, which is attached to the anterior nasal spine and septum, in the midline. The lateral crura compose the second-leg and the third-leg of the tripod, and are attached to the (pear-shaped) pyriform aperture, the nasal-cavity opening at the front of the skull. The dome of the nostrils defines the apex of the alar cartilage, which supports the nasal tip, and is responsible for the light reflex of the tip. NYC rhinoplasty Allentown NJ 08501.
  2. the nasal lining — A thin layer of vascular mucosa that adheres tightly to the deep surface of the bones and the cartilages of the nose. Said dense adherence to the nasal interior limits the mobility of the mucosa, consequently, only the smallest of mucosal defects (< 5 mm) can be sutured primarily.
  3. the nasal skin — A tight envelope that proceeds inferiorly from the glabella (the smooth prominence between the eyebrows), which then becomes thinner and progressively inelastic (less distensible). The skin of the mid-third of the nose covers the cartilaginous dorsum and the upper lateral cartilages and is relatively elastic, but, at the (far) distal-third of the nose, the skin adheres tightly to the alar cartilages, and is little distensible. The skin and the underlying soft tissues of the alar lobule form a semi-rigid anatomic unit that maintains the graceful curve of the alar rim, and the patency (openness) of the nostrils (anterior nares). To preserve this nasal shape and patency, the replacement of the alar lobule must include a supporting cartilage graft — despite the alar lobule not originally containing cartilage; because of its many sebaceous glands, the nasal skin usually is of a smooth (oiled) texture. Moreover, regarding scarrification, when compared to the skin of other facial areas, the skin of the nose generates fine-line scars that usually are inconspicuous, which allows the surgeon to strategically hide the surgical scars. NYC rhinoplasty Allentown NJ 08501.
Principles

The technical principles for the surgical reconstruction of a nose derive from the essential operative principles of plastic surgery: that the applied procedure and technique(s) yield the most satisfactory functional and aesthetic outcome. Hence, the rhinoplastic reconstruction of a new nasal subunit, of virtually normal appearance, can be done in a few procedural stages, using intranasal tissues to correct defects of the mucosacartilage battens to brace against tissue contraction and depression (topographic collapse); axial skin flaps designed from three-dimensional (3-D) templates derived from the topographic subunits of the nose; and the refinement of the resultant correction with the subcutaneous sculpting of bone, cartilage, and flesh. Nonetheless, the physician-surgeon and the rhinoplasty patient must abide the fact that the reconstructed nasal subunit is not a nose proper, but a collagen-glued collage — of forehead skin, cheek skin, mucosa, vestibular lining, nasal septum, and fragments of ear cartilage — which is perceived as a nose only because its contour, skin color, and skin texture are true to the original nose.

Restoration

In nasal reconstruction, the plastic surgeon’s ultimate goal is recreating the shadows, the contours, the skin color, and the skin texture that define the patient’s “normal nose”, as perceived at conversational distance (c. 1.0 metre). Yet, such an aesthetic outcome suggests the application of a more complex surgical approach, which requires that the surgeon balance the patient’s required rhinoplasty, with the patient’s aesthetic ideal (body image). In the context of surgically reconstructing the patient’s physiognomy, the “normal nose” is the three-dimensional (3-D) template for replacing the missing part(s) of a nose (aesthetic nasal subunit, aesthetic nasal segment), which the plastic surgeon re-creates using firm, malleable, modelling materials — such as bonecartilage, and flaps of skin and of tissue. In repairing a partial nasal defect (wound), such as that of the alar lobule (the dome above the nostrils), the surgeon uses the undamaged, opposite (contralateral) side of the nose as the 3-D model to fabricate the anatomic template for recreating the deformed nasal subunit, by molding the malleable template material directly upon the normal, undamaged nasal anatomy. To effect a total nasal reconstruction, the template might derive from quotidian observations of the “normal nose” and from photographs of the patient before he or she suffered the nasal damage.

The surgeon replaces missing parts with tissue of like quality and quantity; nasal lining with mucosa, cartilage with cartilage, bone with bone, and skin with skin that best match the native skin color and skin texture of the damaged nasal subunit. For such surgical repairs, skin flaps are preferable to skin grafts, because skin flaps generally are the superior remedy for matching the color and the texture of nasal skin, better resist tissue contracture, and provide better vascularisation of the nasal skeleton; thus, when there is sufficient skin to allow tissue harvesting, nasal skin is the best source of nasal skin. Furthermore, despite its notable scarring propensity, the nasal skin flap is the prime consideration for nasal reconstruction, because of its greater verisimilitude.

The most effective nasal reconstruction for repairing a defect (wound) of the nasal skin, is to re-create the entire nasal subunit; thus, the wound is enlarged to comprehend the entire nasal subunit. Technically, this surgical principle permits laying the scars in the topographic transition zone(s) between and among adjacent aesthetic subunits, which avoids juxtaposing two different types of skin in the same aesthetic subunit, where the differences of color and texture might prove too noticeable, even when reconstructing a nose with skin flaps. Nonetheless, in the final stage of nasal reconstruction — replicating the “normal nose” anatomy by subcutaneous sculpting, the surgeon does have technical allowance to revise the scars, and render them (more) inconspicuous.