Cranio NY Blog

CranioNY is the blog of New York Craniofacial and Plastic Surgeon, Dr. Nicholas Bastidas.

Lip Surgery

Posted by on 7:08 pm in Adult Plastic Surgery, Conditions Treated, Lip Surgery | 0 comments

 

Lip Surgery

The lips are the center of facial expression and reconstruction requires a thorough understanding of the anatomy.  The upper lip is in the shape of a bow, and has a central fullness known as the tubercle.  The depression above the center of the is known as the philtral dimple.

Plastic surgeons are often consulted for lip reconstruction for post-ablative tumor resection and for trauma.  The reconstruction may consist of moving adjacent lip tissue and elements of the cheek to achieve a functional and aesthetic lip.

Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.

Laser Surgery

Posted by on 7:07 pm in Adult Plastic Surgery, Conditions Treated, Laser Surgery | 0 comments

Laser Surgery

 

Laser Surgery | Dr. Nicholas Bastidas, New York Craniofacial and Plastic Surgeon

Laser Surgery

Laser Surgery | Dr. Nicholas Bastidas, New York Craniofacial and Plastic SurgeonAn ablative or non-ablative laser maybe used for removing lesions and for skin resurfacing.

Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.

Ear Reconstruction

Posted by on 4:02 pm in Adult Plastic Surgery, Conditions Treated, Ear Surgery | 0 comments

Ear Reconstruction

 

Ear Reconstruction Preoperative

Preoperative

Torn Ear Lobes

Heavy earrings worn for long-term can lead to stretching of the holes and sometimes complete tears of the earlobe.  Torn ear lobes can be easily repaired under local anesthesia and the ears can be pierced again after 3-6 months.

Ear Reconstruction Postoperative

Postoperative Lobule Reconstruction

Trauma/Cancer

Defects of the ear resulting from trauma or skin cancer may require extensive reconstruction of the cartilage and skin of the external ear.  These reconstructions are typically performed in one or two stages.

Macrotia

 

 

 

 

 

 

Microtia –(small or absent ear)

Malformation of the external ear may require complex reconstruction requiring the use of cartilage from the rib.  This reconstruction is usually postponed until a minimum age of eight to allow for growth of the rib cage.  A new ear framework is sculpted from the cartilages and buried underneath the skin where the new ear is to be created.  Approximately three months later the “new ear” is elevated from underneath the skin and grafted to create the “normal” projection.  Prosthethics are also available, however, are prone to fall off and degrade requiring expensive replacements.  The cartilage sculpted ear is the preferred “permanent” reconstruction recommended by most plastic surgeons and are more resistant to infections than synthetic ears.

Large ears may also be reduced using techniques involving removal of skin and cartilage.  Scars are placed in the shadows of the ear creases to conceal any evidence of surgery.

Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.

Cranioplasty

Posted by on 3:58 pm in Adult Plastic Surgery, Conditions Treated, Cranioplasty | 0 comments

Cranioplasty

 

Cranioplasty | Dr. Nicholas Bastidas, New York Craniofacial and Plastic Surgeon

 Cranioplasty

Trauma from motor vehicle accidents and infection may often leave large defects in the skull creating significant irregularities and deformities in the scalp.  Working with Neurosurgeons, Plastic Surgeons can utilize bone grafts, titanium or plastic implants to recreate the normal contour of the skull and protect the underlying brain.  Tissue expanders (balloons) may need to be placed to stretch the scalp skin to accommodate the implant prior to the final reconstruction.  Customized implants may be used designed based on 3D CT scans to personalize your reconstruction needs.

Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.

Chin Surgery

Posted by on 1:31 pm in Adult Plastic Surgery, Conditions Treated | 0 comments

 

Chin Surgery

Chin projection is important in the facial profile, and the lack of adequate projection can lead to a sagging neck and the appearance of a larger than normal nose.   The projection can be augmented using either a silicone implant or by cutting and moving the chin bone anteriorly.   A small incision inside the mouth or under the chin  can be used to achieve either purpose.  Through a similar approach, removing the prominent bone can reduce a large chin.

Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.

Vascular Malformation

Posted by on 1:04 am in Conditions Treated, Pediatric Plastic Surgery, Vascular Anomalies / Birthmarks | 0 comments

Vascular Malformation

 

Vascular Malformation

Vascular Malformation| Dr. Nicholas Bastidas, New York Craniofacial and Plastic SurgeonVascular malformations are abnormal growths of either arteries, veins, lymphatic vessels and capillaries.   Port wine stain (see photos), is a capillary malformation, and may affect a significant area of the face.  Capillary malformations may be more receptive to laser surgery treatment, though many laser procedures are often required to see a benefit and relapse is unfortunately common.

Arterial malformations are often pulsatile and can be very difficult to treat as recurrence is common.  Surgical therapy is often combined with sclerotherapy (injections to clot off the feeding vessels) to help shrink the malformation and possibly reduce surgical bleeding.

 

Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.

Hemangioma

Posted by on 12:58 am in Conditions Treated, Pediatric Plastic Surgery, Vascular Anomalies / Birthmarks | 0 comments

Hemangioma

 

 

Hemangioma

A hemangioma is a benign vascular tumor that may be present at birth or appear shortly after birth.  It may grow rapidly from a small pin sized red dot to a large mass (tumor) during the first few months of life.  The tumors are composed of small blood vessels (capillaries) that may ulcerate causing pain or may even bleed.  Most fade away to a fleshy colored fatty mass in later childhood (5-7yrs old) but often require surgical excision to improve the contour of the affected area.  Medical treatment may involve a medication called propanolol to induce regression in areas where surgical treatment is not optimal. Laser treatment can also be used but since it only penetrates about 1mm, it is not optimal for thicker tumors.

    Medical Treatment: Propanolol

  
Initially used to treat cardiac problems an amazing side effect of reducing the size of large hemangiomas was noted.  Propanolol is now the gold standard for the treatment of complicated hemangiomas.  Hospital admission for administering the drug is required for monitoring , and the results can be dramatic.

    Surgical Treatment:

Removal of all, or part of the hemagioma is the goal of surgery.  Surgery is indicated for hemagiomas that may bleed or are painful, are unsightly, or that are causing deformation of neighboring normal anatomic structures.

 

 

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Pre-Treatment Hemangioma

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Post-propanolol and adjunctive surgical debulking

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Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.

Treacher Collins

Posted by on 12:49 am in Conditions Treated, Pediatric Plastic Surgery, Treacher Collins | 0 comments

Treacher Collins

 

Treacher Collins | Dr. Nicholas Bastidas, New York Craniofacial and Plastic Surgeon

Treacher collins

Treacher collins syndrome can be genetically inherited or occur as new mutations and cause a pattern of facial clefting as well as a small lower jaw.  Treatment is aimed at first improving the anterior projection of the lower jaw  and opening up the airway which is often using mandible distraction techniques.  This will pull the tongue base forward and open up the airway, possibly reducing the need for tracheotomy.

  •     Excision of ear remnants (6mos)
  •     Defect in the lower lid (coloboma)
  •    Bone grafts can be placed in the cheek areas to augment the bony deficiency (age 5)
  •     Microtia (Age 8-10)
Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.

Scar Revision/Trauma

Posted by on 12:44 am in Adult Plastic Surgery, Conditions Treated, Pediatric Plastic Surgery, Scar Revision/Trauma | 0 comments

Scar Revision/Trauma

 

Trauma | Dr. Nicholas Bastidas, New York Craniofacial and Plastic Surgeon

Patient Model

 

FACT: Any break in the skin that penetrates to the deep dermis will leave a scar

As mere mortals, there is almost nothing we can do to prevent scar formation, but we do have techniques that allow us to minimize the amount of scars formed.  How much scar we form is based on many things, most importantly: genetics, tension on the skin when closed, anatomic location, and surgeon’s ability.

As a plastic surgeon, we are trained in techniques to help minimize scarring by manipulating the tissues to achieve tension free closure and skin edge eversion.  Scars take 6 months to 1 year to fully mature (permanent result) and sometimes steroid injections and silicone tape may be needed to help soften these scars.

Plastic surgeons are often called to the emergency room to treat patients with complicated cuts (lacerations).  Patients who are unhappy with their existing scars may benefit from a scar revision, where the old scar is removed and the tissues closed with plastic surgery techniques.

 

 

 

 

 

 

Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.

Alopecia

Posted by on 12:28 am in Conditions Treated, Pediatric Plastic Surgery, Scalp Reconstruction | 0 comments

 

Scalp Reconstruction

Cancers or trauma can leave large defects in the scalp or areas of missing hair (alopecia).  Large rotational flaps or sometimes tissue expanders (balloons) are needed to re-establish the hairline (remove areas of alopecia) and close complex scalp wounds.

Dr. Nicholas Bastidas is a plastic and reconstructive surgeon specializing in the treatment of pediatric and adult craniofacial, cleft and vascular abnormalities. Dr. Bastidas is a leader in craniofacial surgical procedures and serves the Long Island and greater New York region. Call us today at (516) 497-7900. We are looking forward to serving you and your family.