Riverside Facial Plastic Surgery and Sinus Center

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Celebrity Plastic Surgery by Frank J. Scaccia, M.D., F.A.C.S.
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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.

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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

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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

 

Skin Lesions Removal Bradley Beach NJ 07720

 

cutaneous condition is any medical condition that affects the integumentary system — the organ system that encloses the body and includes skinhairnails, and related muscle and glands. The major function of this system is as a barrier against the external environment. Skin lesions Bradley Beach NJ 07720.

Conditions of the human integumentary system constitute a broad spectrum of diseases, also known as dermatoses, as well as many nonpathologic states (like, in certain circumstances, melanonychia and racquet nails). While only a small number of skin diseases account for most visits to the physician, thousands of skin conditions have been described. Classification of these conditions often presents many nosological challenges, since underlying etiologies and pathogenetics are often not known. Therefore, most current textbooks present a classification based on location (for example, conditions of the mucous membrane), morphology (chronic blistering conditions), etiology (skin conditions resulting from physical factors), and so on.

Clinically, the diagnosis of any particular skin condition is made by gathering pertinent information regarding the presenting skin lesion(s), including the location (such as arms, head, legs), symptoms (pruritus, pain), duration (acute or chronic), arrangement (solitary, generalized, annular, linear), morphology (macules, papulesvesicles), and color (red, blue, brown, black, white, yellow). The diagnosis of many conditions often also requires a skin biopsy which yields histologic information  that can be correlated with the clinical presentation and any laboratory data. Skin lesions Bradley Beach NJ 07720.

The skin weighs an average of 4 kilograms (8.8 lb), covers an area of 2 square metres (22 sq ft), and is made of three distinct layers: the epidermisdermis, andsubcutaneous tissue. There are two main types of human skin: glabrous skin, the nonhairy skin on the palms and soles (also referred to as the "palmoplantar" surfaces), and hair-bearing skin. Within the latter type, there are hairs in structures called pilosebaceous units, each with hair folliclesebaceous gland, and associated arrector pilimuscle. In the embryo, the epidermis, hair, and glands are from the ectoderm, which is chemically influenced by the underlying mesoderm that forms the dermis and subcutaneous tissues. Skin lesions Bradley Beach NJ 07720.

 

Epidermis Bradley Beach NJ 07720

The epidermis is the most superficial layer of skin, a squamous epithelium with several strata: the stratum corneumstratum lucidumstratum granulosumstratum spinosum, and stratum basale. Nourishment is provided to these layers via diffusion from the dermis, since the epidermis is without direct blood supply. The epidermis contains four cell types: keratinocytesmelanocytesLangerhans cells, and Merkel cells. Of these, keratinocytes are the major component, constituting roughly 95 percent of the epidermis. This stratified squamous epithelium is maintained by cell division within the stratum basale, in which differentiating cells slowly displace outwards through the stratum spinosum to the stratum corneum, where cells are continually shed from the surface. In normal skin, the rate of production equals the rate of loss; it takes about two weeks for a cell to migrate from the basal cell layer to the top of the granular cell layer, and an additional two weeks to cross the stratum corneum. Skin lesions Bradley Beach NJ 07720.

Dermis Bradley Beach NJ 07720

The dermis is the layer of skin between the epidermis and subcutaneous tissue, and comprises two sections, the papillary dermis and the reticular dermis. The superficial papillary dermis interdigitates with the overlying rete ridges of the epidermis, between which the two layers interact through the basement membrane zone. Structural components of the dermis are collagenelastic fibers, and ground substance also called extra fibrillar matrix. Within these components are the pilosebaceous units, arrector pili muscles, and the eccrine and apocrine glands. The dermis contains two vascular networks that run parallel to the skin surface—one superficial and one deep plexus—which are connected by vertical communicating vessels. The function of blood vessels within the dermis is fourfold: to supply nutrition, to regulate temperature, to modulate inflammation, and to participate in wound healing. Skin lesions Bradley Beach NJ 07720.

Subcutaneous tissue Bradley Beach NJ 07720

The subcutaneous tissue is a layer of fat between the dermis and underlying fascia. This tissue may be further divided into two components, the actual fatty layer, orpanniculus adiposus, and a deeper vestigial layer of muscle, the panniculus carnosus. The main cellular component of this tissue is the adipocyte, or fat cell. The structure of this tissue is composed of septal (i.e. linear strands) and lobular compartments, which differ in microscopic appearance. Functionally, the subcutaneous fat insulates the body, absorbs trauma, and serves as a reserve energy source.

The physical examination of the skin and its appendages, as well as the mucous membranes, forms the cornerstone of an accurate diagnosis of cutaneous conditions. Most of these conditions present with cutaneous surface changes termed "lesions," which have more or less distinct characteristics. Often proper examination will lead the physician to obtain appropriate historical information and/or laboratory tests that are able to confirm the diagnosis. Upon examination, the important clinical observations are the (1) morphology, (2) configuration, and (3) distribution of the lesion(s). With regard to morphology, the initial lesion that characterizes a condition is known as the "primary lesion," and identification of such a lesions is the most important aspect of the cutaneous examination. Over time, these primary lesions may continue to develop or be modified by regression or trauma, producing "secondary lesions." However, with that being stated, the lack of standardization of basic dermatologic terminology has been one of the principal barriers to successful communication among physicians in describing cutaneous findings. Nevertheless, there are some commonly accepted terms used to describe the macroscopic morphology, configuration, and distribution of skin lesions, which are listed below. Skin lesions Bradley Beach NJ 07720.

Morphology Bradley Beach NJ 07720

Primary lesions

  • Macule – A macule is a change in surface color, without elevation or depression and, therefore, nonpalpable, well or ill-defined, variously sized, but generally considered less than either 5 or 10 mm in diameter at the widest point.
  • Patch – A patch is a large macule equal to or greater than either 5 or 10 mm across, depending on one's definition of a macule. Patches may have some subtle surface change, such as a fine scale or wrinkling, but although the consistency of the surface is changed, the lesion itself is not palpable.
  • Papule – A papule is a circumscribed, solid elevation of skin with no visible fluid, varying in size from a pinhead to less than either 5 or 10 mm in diameter at the widest point.
  • Plaque – A plaque has been described as a broad papule, or confluence of papules equal to or greater than 1 cm, or alternatively as an elevated, plateau-like lesion that is greater in its diameter than in its depth.
  • Nodule – A nodule is morphologically similar to a papule, but is greater than either 5 or 10 mm in both width and depth, and most frequently centered in the dermis or subcutaneous fat. The depth of involvement is what differentiates a nodule from a papule.
  • Vesicle – A vesicle is a circumscribed, fluid-containing, epidermal elevation generally considered less than either 5 or 10 mm in diameter at the widest point.
  • Bulla – A bulla is a large vesicle described as a rounded or irregularly shaped blister containing serous or seropurulent fluid, equal to or greater than either 5 or 10 mm, depending on one's definition of a vesicle
  • Pustule – A pustule is a small elevation of the skin containing cloudy or purulent material usually consisting of necrotic inflammatory cells. These can be either white or red.
  • Cyst – A cyst is an epithelial-lined cavity containing liquid, semi-solid, or solid material.
  • Erosion – An erosion is a discontinuity of the skin exhibiting incomplete loss of the epidermis, a lesion that is moist, circumscribed, and usually depressed.
  • Ulcer – An ulcer is a discontinuity of the skin exhibiting complete loss of the epidermis and often portions of the dermis and even subcutaneous fat.
  • Fissure – A fissure is a crack in the skin that is usually narrow but deep.
  • Wheal – A wheal is a rounded or flat-topped, pale red papule or plaque that is characteristically evanescent, disappearing within 24 to 48 hours. The temporary raised bubble of taut skin on the site of a properly-delivered intradermal injection is also called a wheal, with the ID injection process itself frequently referred to as simply "raising a wheal" in medical texts.
  • Telangiectasia – A telangiectasia represents an enlargement of superficial blood vessels to the point of being visible.
  • Burrow – A burrow appears as a slightly elevated, grayish, tortuous line in the skin, and is caused by burrowing organisms.

Secondary lesions

  • Scale – dry or greasy laminated masses of keratin that represent thickened stratum corneum.
  • Crust – dried serum, pus, or blood usually mixed with epithelial and sometimes bacterial debris.
  • Lichenification – epidermal thickening characterized by visible and palpable thickening of the skin with accentuated skin markings.
  • Excoriation – a punctate or linear abrasion produced by mechanical means (often scratching), usually involving only the epidermis, but commonly reaching the papillary dermis.
  • Induration – dermal thickening causing the cutaneous surface to feel thicker and firmer.
  • Atrophy – refers to a loss of tissue, and can be epidermal, dermal, or subcutaneous. With epidermal atrophy, the skin appears thin, translucent, and wrinkled. Dermal or subcutaneous atrophy is represented by depression of the skin.
  • Maceration – softening and turning white of the skin due to being consistently wet.
  • Umbilication – formation of a depression at the top of a papule, vesicle, or pustule.

Configuration

"Configuration" refers to how lesions are locally grouped ("organized"), which contrasts with how they are distributed (see next section). Skin lesions Bradley Beach NJ 07720.

  • Agminate - in clusters
  • Annular or circinate - ring-shaped
  • Arciform or arcuate - arc-shaped
  • Digitate - with finger-like projections
  • Discoid or nummular - round or disc-shaped
  • Figurate - with a particular shape
  • Guttate - resembling drops
  • Gyrate - coiled or spiral-shaped
  • Herpetiform - resembling herpes
  • Linear
  • Mamillated - with rounded, breast-like projections
  • Reticular or reticulated - resembling a net
  • Serpiginous - with a wavy border
  • Stellate - star-shaped
  • Targetoid - resembling a bullseye
  • Verrucous - wart-like

Distribution

"Distribution" refers to how lesions are localized. They may be confined to a single area (a patch) or may exist in several places. Some distributions correlate with the means by which a given area becomes affected. For example, contact dermatitis correlates with locations where allergen has elicited an allergic immune response. Varicella zoster virus is known to recur (after its initial presentation as chicken pox) as herpes zoster ("shingles"). Chicken pox appears nearly everywhere on the body, but herpes zoster tends to follow one or two dermatomes; for example, the eruptions may appear along the bra line, on either or both sides of the patient. Skin lesions Bradley Beach NJ 07720.

  • Generalized
  • Symmetric - one side mirrors the other
  • Flexural - on the front of the fingers
  • Extensor - on the back of the fingers
  • Intertriginous - in an area where two skin areas may touch or rub together
  • Morbilliform - resembling measles
  • Palmoplantar - on the palm of the hand or bottom of the foot
  • Periorificial - around an orifice such as the mouth
  • Periungual - under a fingernail or toenail
  • Blaschkoid - following the path of Blaschko's lines in the skin
  • Photodistributed - in places where sunlight reaches
  • Zosteriform or dermatomal - associated with a particular nerve