Rhinoplasty in Chicago

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Rhinoplasty is considered by many facial plastic surgeons, in Chicago and abroad, to be one of the most difficult cosmetic procedures to conduct. In Chicago, rhinoplasty is performed by a handful of trained facial plastic surgeons who have specifically studied both otolaryngology and facial plastic surgery in order to ensure that both your aesthetic concerns and anatomic functionality are looked after.

Dr. Dayan's Approach

Based on certain fundamental principles of beauty, Dr. Dayan approaches rhinoplasty in a way that focuses attention toward the eyes to help increase your level of attractiveness. Dr. Dayan is an expert in the science of beauty and shares his understanding of beauty through his undergraduate course at DePaul University titled, "The Science of Beauty, Attraction, and Its Impact on Culture and Business." He has an in-depth understanding and appreciation for the subtle changes in a face that can lead to improving the first impression and level of attractiveness one exhibits.

Depending on the type of rhinoplasty the patient receives, small, well-hidden incisions are made inside of the nose. Cartilage and bone are then refined to create a smoother aesthetic. For those affected by a deviated septum (a condition where the bone or cartilage is actually obstructing the nasal cavity), Dr. Dayan may perform a septoplasty. During this procedure, cartilage or bone may be removed from the nose. Some patients have reported that this procedure actually improved their breathing.

Recovering From Rhinoplasty

Depending on the specific case, the nasal splint is removed approximately one week after surgery. Many patients begin to see results within 2-4 weeks. Discomfort is typically minimal; however, pain medication is available as necessary. After surgery, sun exposure and pressure on the nose is discouraged.

Your Consultation

There are several factors which your medical provider must consider when deciding which approach is ideal for you. A consultation is strongly suggested to determine your specific needs. Schedule a consultation now.

Revision Rhinoplasty

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Revision Rhinoplasty is an advanced procedure that requires highly sophisticated training, expert techniques and a deep understanding and appreciation of the delicate intricacies of the nose. Rhinoplasty is arguably the most difficult cosmetic procedure in which to achieve a perfect result.

Additionally, the nose serves a very important role in the mechanics of breathing. While a dissatisfying outcome in nasal cosmetic surgery is possible even in the most skilled hands, more commonly it comes from the hands of the occasional nasal surgeon. Revision rates with inexperienced physicians have been reported to be as high as 20%.

Patients who have had a rhinoplasty with another surgeon and are not satisfied with their results seek Dr. Steven H. Dayan for his precise skill and vast experience with this procedure. Dr. Steven H. Dayan works with each patient to ensure your revision will change the way you feel, look and breathe.

The decision to have a revision can be a difficult and often emotional one. Dr. Steven H. Dayan believes in approaching the procedure as your partner. He works with you to ensure that all of your concerns are discussed and that he clearly understands your goals. Dr. Steven H. Dayan believes that those seeking revision surgery need to be advised honestly about what they can expect. He uses a state-of-the art computer imaging system as a tool to visually communicate options for your procedure. His extensive training and specialized knowledge of the nose, allow him to repair the breathing mechanisms while correcting and enhancing the appearance. His artistic eye and unique understanding of facial angles and proportions helps create the ideal balance for functional and aesthetic procedures. Dr. Steven H. Dayan will work closely with you to ensure a healthy, happy outcome.

To contact Dr. Steven H. Dayan about revision rhinoplasty, click here.

Ethnic Rhinoplasty

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Although I am frequently asked about "ethnic" rhinoplasty by patients, the definition of an ethnic rhinoplasty is relative and varies greatly based on perspective. What someone in Chicago considers an ethnic rhinoplasty may be different from what is thought to be "ethnic" in Los Angeles, Miami or Maine.  Recently I was in Tokyo and Seoul discussing my techniques for Asian rhinoplasty, and when my colleagues asked me about ethnic rhinoplasty, they were referring to a Caucasian nose. Cosmetic rhinoplasty has its roots in the early part of the 20th century and began as an operation that would allow someone to hide their ethnicity. It was on operation popularized in Germany by Dr. Jacques Joseph for Middle Eastern, Eastern European and Russian descendants who wanted a more German looking nose. The operation quickly caught on in America when pioneering and forward thinking American surgeons including my great uncle Sam Fomon, went to learn from Dr. Joseph. They brought back this curious image altering procedure, and it gained popularity in NYC especially among the Irish and Jewish immigrants wanting to appear more American. The "American nose" was shorter scooped out tiny tip nose typified by twiggy the American iconic star of the 50's.

The goal was still to hide one's ethnicity. However, America started to change as many more immigrants moved to this country and the appearance of what is beautiful also changed. Beauty in a population is defined by what is the average of all the people in that group. So as America absorbed more peoples from Africa, South America and Asia our definition of what is beautiful also migrated. Today what is beautiful is no longer a turned up nose, wide open eyes or well defined lips rather it is fuller eyes (Catherine Zeta Jones), a slightly wider nose (Halle Berry) and fuller lips (Anjolie Jolie). Our goal today is rather to create a more symmetric nose that blends with the average of society but still allows for identity of one's original ethnic roots. It is uncommon for a person to ask for a race-changing nose today although on occasion it happens. Most patients just want their nose, but better, one they can feel proud of whether at their family reunion or at their multicultural college campus. The aesthetics of the nose do vary based on region and culture, so it is critically important to be very sensitive and understand the goals of each individual.

My first 5 years of performing rhinoplasty were on patients of African American and Asian descent. Over the last ten years, I have gained enormous experience operating on such noses and have developed unique techniques to preserve ethnicity and keep the procedure a secret. It seems especially important for my patients who are in the media spotlight whose career could be ruined if the fact they had a rhinoplasty became public.

 

Patients of African, Hispanic and Asian descent tend to have thicker skin, wider nasal bases, limited caudal septal support and a lower dorsum (bridge). A common request is a higher bridge (dorsum), narrowed tip and narrowed nostril base. However the techniques that would achieve such results in a Caucasian nose are completely different for an ethnic nose. The bridge while appearing wide will not be narrowed by breaking the nose, (lateral osteotomies) rather the bridge has to be augmented. In Asia, foreign body grafts such silastic implants and fillers are popular.  In the United States, however, these are less popular as we tend to be concerned about the infection and rejection rates associated with these products. We tend to use cartilage and soft tissue materials that come from the patient's nose, ear or rib. Therefore there is no chance for rejection. Yes it does take more time but in the long run it may be a better solution.

The nasal tip in order to be narrowed needs more projection and support. "Ethnic" noses tend to have thin lower lateral (tip) cartilages and weak support to the tip. In other words if you push on the tip it is easily depressed almost all the way down and springs back slowly. In order to provide thinning and more definition to the tip it will need support usually achieved with a caudal septal extension graft and tongue in groove maneuver. These are stabilizing grafts that use the patient's own septal cartilage. For more information on these grafts see my lecture to the Australian Society of Facial Plastic Surgeons. Often the lower lateral cartilage and tip will need additional augmentation and this can be achieved with soft tissue and fascia taken from behind the nose or if additional is needed from behind the ear.

Because the "ethnic" nose tends to have thicker skin and is at higher risk for swelling and scaring, a closed rhinoplasty approach with all incision hidden on the inside of the nose is particularly favored and beneficial. Nothing could be worse than a nicely shaped nose ruined by a horrible scar on the columellar (skin between the nostrils).  Additionally keeping swelling to a minimum is essential. Excess swelling can lead to permanent changes in the nose such as poly beak formation (nose looks like a parrot beak).  It is my opinion that the closed approach with less surgical dissection and quicker operative times is very important to reducing the risk for post operative swelling.

There are multiple other measures that I use during surgery to reduce the risk of swelling from smaller instruments, to specific medications given during surgery and special stitches. All of these seemingly minor steps are very important swelling reduction maneuvers that I have learned and developed over years from performing and teaching of ethnic rhinoplasty.

If you are considering undergoing a rhinoplasty and are of ethnic descent, make sure your physician is very experienced with treating people with noses similar to yours. Ask to see photos, talk to other patients and ask for your doctor's philosophy on "ethnic rhinoplasty."

Questions to ask before undergoing Ethnic rhinoplasty, in addition to "The 15 Rhinoplasty Questions."

• How many ethnic noses have you done?
• What measures do you use differently from Caucasian noses?
• Do you use grafting material that is a foreign?
• Will you break my nose?
• Are you worried about scarring in my nose?
• What will you do to prevent excessive swelling?
• Do you do the closed approach and if not why?

Common Conditions:

• Hump reduction
• Bulbous Tip
• Crooked Nose
• Long Nose
• Wide/flat nose
• Short nose
• Saddle Nose

Contact Dr. Steven H. Dayan about ethnic rhinoplasty.

Eyelid Surgery (Blepharoplasty)

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Inviting eyes are essential to a youthful appearance. Much of what facial plastic surgeons do is divert attention from other parts of the face to the eyes, which are usually the most engaging and eye catching spot on the face. The eyes are what create uniqueness and depth to the face, and patients want others to focus on this area. Unfortunately, it is also the first part of the face to show aging. In certain families, aging eyelids are hereditary, characterized by excess upper eyelid skin and bulging bags under the eyes. This may present itself as early as the late teens to early twenties. Fine wrinkles of the lateral eyelid skin, also known as crow's feet, surface as early as the late twenties. Although blepharoplasty is often done in isolation, those undergoing facelifts should take a close look at their eyes as well.

If eyelid surgery or blepharoplasty is done in conjunction with a facelift, it can improve overall appearance. Some individuals may experience obstructed vision from overly redundant upper eyelid skin. Blepharoplasty then becomes a medically necessary procedure and may be reimbursable by third party payers.

There are some limitations to blepharoplasty, and patients should recognize them. Fine wrinkles of the lateral crow's feet area will not gain an appreciable benefit from blepharoplasty alone. However, laser resurfacing or medium-strength chemical peels are options that can tighten up this area and reduce fine wrinkles. Fortunately, here in Chicago, eyelid surgery patients can take advantage of regular skin care services at True Skin Care Center. Excess upper eyelid skin may be partially due to descended eyebrows, and if this is the case, an eyebrow lift or forehead lift may be necessary to complete or maximize your result.

When properly carried out, blepharoplasty is a favorable procedure that eliminates a fatigued and tired look common to aging. The best candidate for eyelid surgery is a physically healthy man or woman who has realistic expectations and is looking to improve the appearance of drooping upper eyelids and/or puffy bags beneath the eyes. Eyelid surgery typically takes between one and three hours to complete, and can be performed in a surgeon's office-based facility, a hospital or an outpatient surgery center. General anesthesia or a combination of local anesthesia and sedation is most often used.

Contact Steven H. Dayan, M.D.,FACS about eyelid surgery

As we age, time, and it seems the laws of gravity, take a toll on our faces. Sometimes our faces portray an older appearance than how we feel inside. Steven H. Dayan's approach to aesthetic medicine, however, will be the anti-gravity solution to your facial aging dilemmas, leaving you looking and feeling your very best.

Chin Implant Procedures

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An underdeveloped chin is often an oversight that is not recognized by the patient. Although frequently done as an isolated procedure, chin augmentation can place the finishing touches on other facial surgery. A weak chin can give the appearance of a large nose or a short neckline, and in males, a recessed chin may lead to a false perception of timidity or weakness. By augmenting the chin, we can give overall facial balance improving proportions of the face and accentuating the improvement in a rhinoplasty or facelift.

In an article Dr. Dayan published in Plastic Reconstructive Surgery. He shows that a chin implant can also improve the contours of the neckline. This is another added benefit of a chin implant.

If you decide to undergo this procedure, it can be one of the most satisfying procedures performed in facial plastic surgery. Dramatic improvements can be realized with only a small, subtle change, and patients are generally very gratified.

The best candidate for chin augmentation surgery is a physically healthy man or woman who is realistic in their expectations and looking to augment the chin in order to provide better balance to the whole of the face and the profile.

Chin implant surgery is typically performed with either local anesthesia and sedation, or with general anesthesia. This procedure takes anywhere from thirty minutes to three hours to complete, and may take place in a surgeon's office-based facility, an outpatient surgical center or in a hospital.

Contact Steven H. Dayan, M.D., FACS about chin augmentation.

Face & Necklift Procedures

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Face & Necklift Procedures

A facelift, one of the most commonly performed procedures, provides a remarkable improvement in your appearance. Facelifting is the ideal treatment for correcting a sagging jaw line, falling cheeks and a blunted neckline. There are many methods to facelifting, and advancements in this procedure have evolved significantly over the last ten years. It wasn't too long ago that surgeons would approach facelifting by pulling the skin tighter. Unfortunately, this resulted in an unnatural wind blown or stretched look. Today, we have newer and better techniques to relocate the deeper tissues and just drape the skin tension free over the repositioned tissues. This gives a more natural, longer lasting result.

Each facelift patient undergoing a facelift procedure would like to know how long the results will last and will anybody know they had it done? Answers to these questions depend on your underlying anatomy, your individual desires, and how much aging is evident on your face. Irrespective of your age, you can expect a facelift to improve your appearance and personal outlook. You should appear younger, with a well rested, healthy look. The younger you are, the longer you can expect the facelift results to last. If you are older, you will experience a more dramatic improvement, however, there is also a greater possibility of tissue rebounding. Incisions are hidden behind the ears and in natural skin creases; these usually heal as thin thread-like lines which are well camouflaged.

Following facelift surgery, you can decide to go home or spend the night in the hospital. Pain is uncommon, but we will prescribe medication to ensure your comfort. Ten days to two weeks after surgery, most patients return to normal social activities while enjoying the benefits of a more youthful appearance.

An underdeveloped chin is often an oversight not recognized by the patient. Although frequently done as an isolated procedure, chin augmentation can place the finishing touches on other facial surgery. A weak chin can give the appearance of a large nose or a short neckline. In males, a recessed chin may lead to a false perception of timidness or weakness. By augmenting the chin, we can give overall facial balance improving proportions of the face and accentuating the improvement in a rhinoplasty or a facelift.

If you decide to undergo this procedure, it really can make a dramatic improvement with only a small, subtle change. Patients are generally very gratified. The best candidate for a facelift (Quiet Lift) is a physically healthy man or woman who is realistic about their expectations, and interested in improving sagging facial skin, jowls, and loose neck skin. Most patients undergoing facelifts are over the age of forty. The procedure typically takes several hours to complete and can take place in a surgeon's office-based facility, a hospital or an outpatient surgery center. General anesthesia or a combination of local anesthesia and sedation is most often used during facelift surgery.

Contact Steven H. Dayan, M.D., FACS about facelift surgery

As we age, time, and it seems the laws of gravity, take a toll on our faces. Sometimes our faces portray an older appearance than how we feel inside. Dr. Steven H. Dayan's approach to aesthetic medicine, however, will be the anti-gravity solution to your facial aging dilemmas, leaving you looking and feeling your very best.

Otoplasty Procedures

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An over-prominence / protrusion of the ears, can be discouraging under any set of circumstances, but when those affected are children, the effects can be truly heartbreaking. It is well-known that kids can be cruel, and it won't take long for your child to notice that they are "different from the other kids". This can lead to feelings of sadness & alienation, and the psychological implications can be grave, if the ostracism persists for a long period of time. However, there is good news to be had - things don't have to be the way they used to be!

Today, cosmetic surgery is both safe and effective when performed on adults. However, the same is true for children, provided adequate care is taken. This is particularly valid when speaking of otoplasty. For those who may be unfamiliar with the term, otoplasty is the medical term for a type of cosmetic ear surgery, which is designed to make your ears smaller and / or less noticeable. After discussing all your options with your physician, it might be decided that otoplasty is the best course for your child. If this is the case, they will be placed under the care of Dr. Steven Dayan for the duration of their treatment. Dr. Dayan is a Chicago-based plastic surgeon, and a board-certified expert in advanced facial plastic and laser surgery.

You may be curious to know whether or not your child is able or ready to receive an otoplasty. Make no mistake, the boost to their confidence and self-image after the operation is complete will be all the proof you need. However, caution is always appropriate, especially when it concerns your children. So, a bit of an explanation might be a welcome thing. The short answer is, yes, your child is ready and able to undergo this procedure, provided certain conditions are met.

If they are an otherwise healthy child, as long as they are six years of age or older, and severely affected by their prominent ears; the otoplasty may be indicated for them. There are, however, some age-specific issues with which you will want to familiarize yourself. Again, we recognize your desire for information, and we believe that forewarned is forearmed. As such, here is a brief overview of age-related topics concerning your child's otoplasty: If your child is between the ages of six and fourteen, they will be placed under general anesthesia. If, however, they are fourteen or older, your child may be given a local anesthetic and / or sedation. The choice of anesthetic, as with all other facets of your child's operation, can be discussed at length with Dr. Dayan and the anesthesiologist beforehand.

The entire operation shouldn't take longer than 1.5 hours, and once your child's incisions have been closed, the operation is complete. After a short time in the recovery room, your child may be discharged. At this point, you may want to explain the concept of "recovery time" to your child. Additionally, it is always advisable to reassure them that no one will see their incisions. The surgeons will have made the incisions themselves behind your child's ears, and thus, out of view. The stitches used to close the incisions will go behind the ears as well, and should dissolve in about a week.

It is normal for your child to experience some soreness, swelling, and other forms of discomfort after their surgery. Any post-operative discomfort can be easily managed through medication. It is important to note that, as with all surgical procedures, there is a chance that scarring will occur. It is important that, if such scarring does happen, that you make sure your child knows that he or she can expect that it won't be visible - the scars, if any, will be behind the ears, and thus, out of public view. If you have any questions, don't hesitate to ask your physician, Dr. Dayan, or another competent medical professional that you trust.

Your child should be ready to return to school (or, if they are older, work / chores), and to resume your normal routine, in approximately one week. However, it is important that you don't allow them to do anything that may cause their ears harm or injury. Such activity should be avoided for approximately three months, but, as always, consult your physician with any questions or concerns.

Contact Steven H. Dayan, M.D, FACS about ear surgery (otoplasty).

Brow Lift Procedures

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The perpetual, dynamic forces of gravity and aging cause the eyebrows and forehead to descend. As the brows fall, they push the redundant skin into the upper eyelid causing a crowded look to the upper eyelid. The brow appears heavy, thickened and deep creases set in between the brows. All this can lead to an angry look or a scowl even when you don't feel this way. Some people look tired, and women may have difficulty placing mascara or other make-up to the area. Many patients seeking rejuvenation surgery are not aware of the sagging eyebrows' participation in their aged appearances. To improve this, a browlift can be done in isolation, but it is usually done in tandem with a forehead lift or a facelift. If you're like most in Chicago, forehead lift and facelift options appeal to those with active lifestyles and careers by offering a more rested, youthful appearance.

Repositioning forehead skin may be necessary to achieve the optimal improvement in eyelid surgery, attracting attention to opened, more inviting eyes. For those with heavy descended brows undergoing a facelift procedure, a forehead lift may be key to maintaining a natural look. It will also help smooth out excess wrinkles, crow's feet and skin of the temporal region. Modern technology has improved the way we perform this procedure. New techniques include using lighted scopes placed through small, well-hidden incisions within your hairline, and this leads to less swelling, bruising and your recovery time is much quicker.

The best candidate for an edoscopic forehead lift is a physically healthy man or woman who has realistic expectations about the forehead lift procedure and is interested in minimizing the appearance of drooping brows, horizontal lines and furrows of the forehead. Although most patients receiving forehead lifts are between the ages of forty and sixty, the procedure can be performed at any age if necessary.

Most forehead lift procedures are done in an outpatient surgery center or a surgeon's office-based facility, though some procedures occasionally take place in a hospital. The forehead lift procedure itself typically takes between one and two hours to complete, and is most commonly performed with a combination of local anesthesia and sedation, although general anesthesia is sometimes used.

Contact Steven H. Dayan, M.D. FACS about brow-lift surgery.

Fat Transfer Procedures

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During the aging process, we lose fullness to our face, resulting in a sunken look. Today, the new thinking in plastic surgery is to replace volume in the face, rather than pull it tighter. Oftentimes, the best option to replace volume is a fat transfer procedure. Fat is harvested through a small incision from either the neck or the abdomen; the fat is then cleansed and concentrated, after which it is injected into the desired area. In those seeking a natural alternative to collagen for plumping facial wrinkles, this is an option. There is minimal swelling and rarely any bruising. Most patients return back to work or play shortly following the procedure.

Good candidates for fat transfer include men and women who are physically healthy, have realistic expectations, and are interested in improving the contour of the face by diminishing lines and/or adding fullness. Most fat transfer procedures are performed in a surgeon's office-based facility and typically involve local anesthesia on the donor recipient sites, and some patients may also be given sedation. The procedure usually takes less than an hour to complete. Fat transfer procedures typically involve very little downtime though some redness, swelling and bruising may occur. Most patients are able to return to work right away, but sun exposure should be limited until the redness and bruising have cleared up.

Contact Steven H. Dayan, M.D., FACS about fat transfer surgery.