Dr. Donald-Wood Smith is a Professor of Plastic Surgery certified by the American Board of Plastic Surgery, who specializes in cosmetic plastic surgery of the face and upper body. Dr. Wood-Smith’s prestigious medical Society affiliations include membership in the American Society of Aesthetic Plastic Surgeons [ASAPS], American Association of Plastic Surgeons, and of the American Society of Maxillofacial Surgeons. He is also member of the British Association of Plastic Surgeons. He is the author of over 100 contributions to the plastic surgery literature including books, chapters and scientific paper presentations, a majority on cosmetic surgery related subjects. His book “Cosmetic Facial Surgery”, co-authored with Dr. Thomas D Rees, represents a foundation of modern cosmetic facial surgery teaching.
He holds the position of Professor of Clinical Plastic Surgery at the Columbia-Presbyterian Hospital and is the Chairman of the Department of Plastic Surgery at the New York Eye and Ear Infirmary. His prior appointments were Chairman of the Department of Plastic Surgery at the Manhattan Eye, Ear and Throat Hospital and Professor of Plastic Surgery at New York University Medical Center. He works closely with each patient to develop an individualized plan of treatment prior to any surgical intervention and is dedicated towards achieving a natural postsurgical look with none of the stigmata of the patient having had “plastic surgery”.
State-of-the-art plastic surgery is provided at the Infirmary in a discrete and luxurious hospital setting, offering both in- patient and outpatient facilities and always in cooperation with some of the best Anesthesiologists in the city. The safety of our patient is of paramount interest in our practice. The latest endoscopic, laser and liposuction equipment is readily available in our operating rooms.
Dr. Wood-Smith’s particular field of interest is in rhinoplasty [nasal plastic], both primary and secondary and he welcomes the challenge of correction of the unhappy postsurgical nasal plastic results for both US and international patients.
Primary nasal plastic [primary rhinoplasty].
Once the patient has made their decision to consult the surgeon perhaps the most important part of the operation is conducted prior to surgery. The Surgeon must ascertain the patient’s ideas for correction and examine the patient face and nose, both externally and internally, in order to evaluate type of surgical correction that will best accommodate the patient’s wishes. In addition to the patient’s description of their desires many will bring photographs illustrating the type of nose that they would ideally like.
The examination of the photographic study of the face follows with the surgeon’s careful computer analysis and a retouching of the photographs in order to best accommodate the patient’s desires. At the same time we preserve the essential nasal functions of both breathing and smelling. Our results are usually accurate to within a millimeter or so after healing has occurred although some variation related to the patient’s healing abilities may rarely occur.
Once the patient has received the photographic study with the proposed changes their study further consultations may be required in order to accommodate any change that the patient wishes to the design. The patient should then have a medical clearance done by their Pediatrician or Internist for the procedure.
Our operations are always performed in a hospital setting, usually under a monitored local anesthetic [deep twilight sleep]. The patient will have no memory of the procedure which is most frequently done on an outpatient basis. I do not advocate “in office surgery” as I feel elective procedures are best done in the safety of a hospital situation. In my practice thousands of such operations have been completed with an extremely low complication rate and no serious problems. There will be no nasal gauze packing nor plastic casts and merely a light tape on the exterior the nose which will be removed on day five or six. Minimal bruising, if any, is to be expected, occurring in our practice in less than one patient in 20 and the patient may realistically schedule modest social or work activity within a week or so of surgery. Pain is not a feature of the procedure, rather a discomfited analogous to the last severe summer cold suffered by the patient. Full athletic activities may usually be resumed six weeks following surgery
The secondary nasal plastic [secondary rhinoplasty]
One of the commonest reasons for an unhappy patient following nasal operations is failure of the Surgeon to present either computer altered photographs or retouched actual photographs showing the expected result following the nasal plastic operation. Indeed, the surgeons comment “trust me I know what you want” without such a step is frequently an open invitation to disaster and in our experience is a factor in well over half of the patients presenting for secondary correction.
Dependent on the problem presented surgery may be simple and quick or may require cartilage or bone grafting in some instances in order to achieve a satisfactory result. One of the more common requests is correction of the scar left on the columella [the divider between the nostrils] as a result of the open technique. This is a procedure that we almost never perform in our practice since scarring is usually impossible to eradicate and frequently is the source of great concern to the patient. Another problem with the open technique is the relative slowness of recovery from such a procedure and we relegate its use complicated cleft lip/nose reconstructions and occasionally to the teaching of beginning surgeons.
These patients require work by surgeon well experienced in this area and even then usually require a longer time of recovery to achieve satisfactory results. In some instances more than one operation may be required to achieve the desired result.