Revisional surgery is a specialty in and of itself because the surgeon is correcting that which has been once corrected. The second procedure holds uncharted waters. It requires a demanding surgical skill set few surgeons can claim. Dr. Kornstein is recognized by peers and patients alike as having the vision, aesthetic sense and ability to transform a “less than optimal” result into the positive change the patient expected the first time. Breast revisions and Revisional Rhinoplasty are two of his specialties.
What it takes to do good revisional work
- What happens to people who undergo plastic surgery in an attempt to improve themselves, but things do not go as planned?
- An aesthetic surgery turns into a reconstructive surgery that requires even more aesthetics, knowledge and creativity: Revisional surgery.
- Why do many revisional patients undergo so many procedures? In general, because the same mistake is being made over and over. In other words, the surgeon is not thinking “outside the box”; they are simply doing same routine procedures. I take great pride in turning patients around, sometimes after multiple surgeries. The patients are very brave to try again; I won’t let them down.
- In order to be successful, one must try to understand what essential anatomic element was missed or misunderstood. Then a plan must be sought, either as a single or stage procedure.
- This requires creativity and innovation. Some of the most common revisional surgeries I see are for:
- Rhinoplasty: Recognizing a specific anatomical variation and knowing how to treat it before the complication arises; many doctors do one rhinoplasty operation and if you anatomy does not fit that operation a poor outcome is the result. That is why your friend can get a good result and in the same hands your result is not satisfactory – *Recent unusual example: patient with injected silicone hardened throughout the tip and bridge
- Facelift: Superficial layers are pulled too much or too often. This tightens the skin over the flattened contours of facial of facial aging, often too much facial fat is removed(because it is out of position) exacerbating the problem. *Recent unusual example: patient with ears pulled forward and temporal hair removed by overly tightened skin
- Lipoplasty: Too much fat, the skins supportive element is removed, leading to gravitational descent and cellulite, esp in the abdomen and outer thigh/buttock regions. Skin contraction was not considered.
- *Recent unusual example: “Smart lipo” created ripples of the abdomen by injuring fine subcutaneous fat layer
- Silicone lips: Ultherapy to remove silicone from lips and face non-surgically.
- Breast: Weakened breast parenchymal anatomy (age, preganancy, weight loss) cannot support the increased demands of the mass of breast implants leading to increased scar tissue and capsular contracture. *Recent unusual example: Over expansion of skin with immediate breast reconstruction