Working in one of the top otolaryngology鈥揾ead and neck surgery departments in the United States, Johns Hopkins鈥� chief of facial cosmetic surgery treats a number of patients who require complex rhinoplasty revision 鈥� a聽 specialty for his practice.
In one recent case, a female patient was experiencing the results of a prior rhinoplasty: a deviated septum, collapsed nostrils and twisted nasal tip. The concerns were not only cosmetic but also functional, with her breathing significantly obstructed. 鈥淓verybody told her no in terms of surgery,鈥� Desai says, due to the significant complexity of the job.
But Desai 鈥斅� who is often sought for advanced work, and has performed hundreds of rhinoplasties in his nine years at Johns Hopkins 鈥� took on the procedure. To reconstruct the patient鈥檚 nose during the five-hour operation, Desai used grafts of cartilage from her ears as well as from the ribs of a cadaver. 鈥淲e got her to a place where she was breathing normally again, and felt more confident being in public with her appearance,鈥� he says.
Improving functionality and cosmetics is the priority for Desai, who is board certified as a facial plastic surgeon and otolaryngologist. He is one of four facial plastic and reconstructive surgeons in the department, which also includes , and . 鈥淲e look at it from a breathing perspective and from an aesthetic perspective, and we don鈥檛 sacrifice one for the other,鈥� he says.
The team members are based out of Bethesda; Green Spring Station in Baltimore County; the Levi Watkins, Jr., M.D., Outpatient Center in Baltimore; and Sibley Memorial Hospital in Washington, D.C.
While skilled in rhinoplasty revisions, Desai says his own practice has established a low rate for surgeries requiring them 鈥� under 3% in a field where the average rate is 5% to 7%,.听
Desai and colleagues also make a point of following patients through long-term healing as their noses take final shape, a nuanced and personalized process that may involve taping, massaging or steroid injections, among other steps. 鈥淲hat makes rhinoplasty such a challenging surgery is the outcome isn鈥檛 judged a week after 鈥� it鈥檚 judged almost one-and-a-half to two years later,鈥� he says. 鈥淵ou really have to follow things over time, and having that patient-physician relationship, knowing we trust each other, is important.鈥�
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