Although oral and maxillofacial surgery is a particularly specialized kind of plastic surgery, it is also growing in popularity as our society evolves. What is maxillofacial and oral surgery? Specialized in reconstructive surgery, oral and maxillofacial surgeons are dentists with additional training in this area. They operate on patients who have face fractures, cleft palates, jaw injuries, and other disorders affecting the mouth or jaw. Additionally, they assist patients in keeping function while improving their appearance by doing cosmetic operations like liposuction and Botox injections.

From children with cleft palates to people who have suffered facial or oral injuries due to accidents or injuries, oral surgeons treat patients from all walks of life. They are in charge of improving these patients’ lives by performing reconstructive procedures that try to give patients their former appearance and function back.

To find out more about the types of sinus surgery, why I would need one, and whether oral and maxillofacial surgery is plastic surgery, continue reading.

As an OMFS, you have honed your surgical skills, which frequently include making sure your patients have good cosmetic results. Consider switching to the specialization of facial cosmetic surgery if you discover that you are passionate about the aesthetic element of your work.

This approach is made possible for interested OMFS with single or dual degrees by the American Board of Facial Cosmetic Surgery (ABFCS). These are the eight essential actions that our board-certified facial cosmetic surgeons advise you to take when preparing for this career transition.

1. Find out if you are suited to the career change

Take time to consider whether you are suited to the career change. While your experience as an OMFS has largely addressed patients’ more straightforward medical needs, cosmetic surgeons’ work involves finding procedure(s) that address patients’ more nuanced requests and requirements. To succeed as a facial cosmetic surgeon, you should both be happy to work with patients’ individual preferences and have a natural aesthetic ability; your patients’ goals become your puzzle to creatively address with cosmetic procedures and treatments.

Reach out to practicing cosmetic surgeons, read about the specialty, and look for opportunities to shadow fellow doctors where possible. Our blog and webpage for surgeons offer insights, and the American Academy of Cosmetic Surgery (AACS) also offers many educational resources and conferences. Surgeons considering fellowship training may also consider reaching out to facial cosmetic fellowship directors, whose contact information is listed on our fellowship webpage.

2. Acquire training, i.e., through a cosmetic fellowship

There are three routes by which an oral and maxillofacial surgeon may specialize their practice and become a board-certified facial cosmetic surgeon: (1) the experience route, (2) the AACS-certified fellowship route (1-2 years), or (3) an equivalent non-AACS fellowship. Surgeons wishing to take the experience route will need to ensure they have extensive and proper documentation of cosmetic surgery cases; those who either prefer fellowship training or require it to gain experience may read more about fellowship training programs here.

3. Update malpractice insurance ahead of your fellowship

Whether you plan to begin offering cosmetic enhancements or are entering an AACS-certified facial cosmetic fellowship, update your malpractice insurance to reflect your change in practice. Cosmetic surgery fellows are also required to obtain an unrestricted medical license in the state where the fellowship is offered. (Fellowships are offered at cosmetic practices across the country).

4. Pass board certification

After you have successfully completed a fellowship or collected evidence of proficiency in facial cosmetic surgery, as well as met other requirements, you may petition the American Board of Facial Cosmetic Surgery (ABFCS) for board certification. Both single- and dual-degree oral and maxillofacial surgeons are eligible. Review requirements and learn how to apply here.

5. Verify that the arrangement of your before-and-after photos complies with cosmetic medicine guidelines.

More than any other specialty, before and after pictures of patients are a vital resource for facial cosmetic surgeons. During consultations, you will use before and after pictures to show patients how skilled you are at surgery and to discuss their desired outcomes. Additionally, you should incorporate some before and after pictures into your marketing materials (with the patient’s permission). For high-quality before and after pictures, uniformity is essential. Make sure your setting is ready ahead of time so you can create a cohesive portfolio of photos that really highlight your work. You will need the following: You and your employees are proficient in using top-notch digital camera equipment with a standard focal length. A tripod to hold the camera steadily in place An unadorned background Great sources of illumination (A variety of artificial and natural light sources will give your images a haphazard, amateurish look.) Patients should wear modest clothing when appropriate. Patients should sign the proper consent paperwork before any pictures are taken. Good before and after photos, especially for facial cosmetic operations, need subtlety and perspectives from several perspectives. In order to create a highly professional portfolio of photographs, you must choose a standard set of poses for every treatment and determine and label the distance that patients will stand or sit from the camera. You might not have enough room to set up a separate “studio” area. The location of the camera and the patient can be marked consistently by placing tape on the floor in front of a simple wall in a consultation or treatment room. Lastly, make sure you can easily incorporate before and after images into your pre-operative and follow-up patient appointments by testing your setup with staff.

6. Recruit or retrain employees to ensure your team is prepared to treat cosmetic patients

At a cosmetic office, staffing requirements are a little different. The majority of cosmetic surgeons use an experienced, compassionate patient care coordinator to guide patients through their process and respond to inquiries that don’t need to be addressed by a qualified medical practitioner. Your operating room and nursing team must also be equipped and trained to conduct cosmetic procedures. Since they will be the first people patients hear when they are considering you for a cosmetic operation, it is crucial that your front desk employees receive training on how to serve aesthetic patients. When it comes to answering patient questions and welcoming patients into the clinic, a skilled cosmetic practice consultant can provide comprehensive guidance. By putting these tips into practice, consultation-to-surgery conversion rates can be significantly raised.

7. Ensure that your workspace is aesthetically pleasing to patients.

One important distinction between patients undergoing aesthetic treatments and those undergoing functional procedures is that the former have a say in the surgeon they choose. In addition to making patients feel valued and cared for, entering a welcoming, attractive, and professional-looking room can also help them trust that you will pay attention to their needs and get the best results possible.

8. Make your marketing more focused on cosmetic operations.

Make sure the operations you provide patients are accurately portrayed in your marketing. Since the majority of patients are looking for an expert, you will only draw in new cosmetic patients if it is obvious that you specialize in cosmetic medicine and are very skilled at producing eye-catching results. Poor patient images, Google listings, outdated or subpar websites, or affiliations with previous practice names may make a patient question your commitment to facial cosmetic surgery.

Learn more about specializing in facial cosmetic surgery

The American Board of Facial Cosmetic Surgery (ABFCS) may allow you to petition for board certification through the experience route if you are an oral and maxillofacial surgeon with a substantial amount of experience performing facial cosmetic surgery.

Types Of Sinus Surgery

Life quality can be negatively impacted by persistent sinus problems. Snoring, sleep apnea, and decreased airflow can all be caused by swollen sinuses. An ENT specialist’s initial course of treatment may involve treating your allergies or writing an antibiotic prescription. Severe instances that don’t improve with this kind of treatment aren’t hopeless. Physicians can undertake sinus surgery to correct the anatomy and enhance function by operating on the nose and sinus cavities. We determine which operations are available to patients and why.

SEPTOPLASTY

An outpatient treatment called septoplasty is used to address problems with the nose’s midline. The procedure reorganizes the septum, which separates the nostrils. Bone and cartilage combine to form the septum. Its function is to facilitate the passage of air into the lungs. The air might stay in the nose without it. The septum can block airflow and drastically alter the volume of air inhaled through the nose, either as a result of an accident (such as a broken nose) or a congenital condition (the nostril pressing against the birthing cavity at birth).

A deviated septum and congestion are additional problems for anyone with chronic sinusitis. By reorganizing the bone and cartilage, septoplasty aims to reorient the alignment and restore airway opening.

TURBINATE DEGRADE

Infection, inflammation, or allergies can cause the turbinates inside the nose to swell and become inflamed. Any of these symptoms could clog the nose and result in an overabundance of mucus. Congestion is caused by an excess of mucus. The nasal tube contains three turbinates: the middle, lower, and higher. They serve to filter, warm, and humidify the air we breathe. They are made up of a mucous membrane and tissue encircling a bone structure.

The goal of turbinate reduction is to lessen swelling and size so that breathing becomes easier. Radiofrequency is frequently needed for the process. A device that resembles a needle is inserted into the turbinate. The tissue receives the radio frequency, which results in “controlled damage.” The size of the turbinate decreases as the nose heals. The size or form of the nose is unaffected by turbinate reduction surgery, and patients shouldn’t anticipate any long-term negative effects.

WORKING RHINOPLASTY

There are two types of rhinoplasty: functional and cosmetic. Fundamentally, rhinoplasty involves reshaping the cartilage and bones that comprise the nose. ENT physicians undertake functional rhinoplasty with the stated goal of assisting the patient in getting rid of irregularities that lead to breathing problems. The nose’s angle and nostril shape both contribute to the airflow that is directed into the lungs. Functional rhinoplasty works well for obstructions that can be treated with antibiotics, allergy medications, or other less invasive techniques. During the procedure, the doctor will resculpt bone and cartilage that sometimes result in a change in nose shape. Physicians can do surgery by making a little incision on the exterior of the nose or from inside.

SINUPLASTY BALLOON

A less invasive technique called balloon sinuplasty is intended to assist patients in reducing the symptoms of persistent sinusitis. A flexible balloon catheter is inserted into the sinus tube by the physician in this simple procedure. A small wire with a flashlight on the end facilitates the process and aids with navigation. The sinus cavity is opened by gradually inflating the balloon after it has been properly positioned. To aid in the removal of the pus and mucus, the physician applies a saline solution. As soon as the fluid begins to drain, many patients experience an immediate reduction in pressure. The balloon’s mild pressure on the sinus cavity aids in the cartilage and bone restructuring. Clearer sinuses should result from its removal.

FESS, or functional endoscopic sinus surgery

FESS, a process that uses a magnification endoscope to see the sinuses and remove any damaged tissue or bone, is perhaps one of the most popular sinus surgery methods available today. Opening the sinus-nose connection is a reconstructive procedure. Better drainage, fewer obstructions, and the removal of infectious material while preserving healthy tissue should be the end outcome, allowing the nose to function normally. The process is endoscopic, as the name implies. In order to use an endoscope—a tiny tube with a camera and light at the end—to examine the inside of the nasal cavity, your ENT surgeon will make tiny incisions within the nose. FESS is frequently carried out in combination with other sinus surgical procedures, such as septoplasty.

What is Sinus Surgery?

To aid patients who are experiencing recurring sinus infections or symptoms, ENTs can perform a series of procedures known as sinus surgery. Antibiotics and allergy medications can occasionally have a negative effect on patients with abnormal growths or structures. Both approaches are the initial call to action for those seeking relief. Sinus surgery enables the physician to open channels and enhance airflow if non-surgical procedures are unable to resolve the issue.

Why Would I Need Surgery for My Sinus?

Sinus surgery is necessary for a number of illnesses in order to assist in reducing symptoms. Sinusitis is among the most prevalent. Swelling of the sinuses and passageways causes sinusitis, which can cause a stuffy nose, pressure in the eyes, forehead, and nose, coughing, nasal discharge, and other symptoms.

A nasal polyp is another frequent cause of surgery. The nasal lining within the nose swells when there are enlarged polyps or clusters of polyps. If they enlarge, a person may have nasal obstructions that could lead to sinus infections and a diminished sense of taste.

Reduced airflow results from deviated septums, which restrict one side of the nose. While there are treatments to lessen nasal tissue swelling that may be causing the deviation, surgery may be necessary to restore airflow balance in certain cases when the patient is unresponsive.

Options for Middle Tennessee Sinus Surgery?

There are little risks or long-term adverse effects associated with any sinus surgical operation. You want to be in the greatest hands, yet surgery is still surgery. One of the best methods to make sure your operation goes well and produces the best results is to work with Board Certified ENT specialists like OAT. Make an appointment by calling OAT right now if you think you may have sinus problems.

Before and after sinus surgery

A persistent infection and inflammation of the sinus and nasal walls are hallmarks of chronic sinusitis. Chronic sinusitis patients may have a number of symptoms, such as “post-nasal drip,” nasal congestion, facial discomfort, and discolored nasal discharge. Your doctor should give you a sinusitis diagnosis only after conducting a thorough evaluation. The majority of sinusitis patients respond well to pharmaceutical treatment for infections. But even after lengthy courses of treatment, infections reappear or continue for a tiny number of patients. For these patients, surgery is frequently beneficial. If you are a surgical candidate, your ear, nose, and throat expert will assess your medical history and x-ray examinations.

What is Endoscopic Sinus Surgery?

In order to restore the sinuses’ natural drainage pathways and function, endoscopic sinus surgery is a treatment that is intended to open them. Chronic sinusitis causes inflammation of the restricted drainage routes, which makes it difficult for the sinuses to drain properly. Nasal secretions may also become lodged in the sinuses and develop into a persistent infection.

The aim of surgery is to gently remove the mucous membranes and thin, delicate bone that obstruct the sinuses’ drainage channels. Utilizing tiny fiberoptic telescopes, “endoscopic” surgery eliminates the need for skin incisions by doing all of the procedures through the nostrils. The majority of endoscopic sinus surgeries are done as outpatient procedures.

What to expect before, during, and after surgery?

Before Surgery:  In preparation for your surgery, your physician may prescribe preoperative medications to optimize the condition of your sinuses for surgery. The medications may include antibiotics and/or oral steroids. Please be sure to start any preoperative medications on the appropriate day and adhere closely to the prescription. In addition, you should avoid taking the following medications for at least fourteen days prior to surgery: aspirin, ibuprofen (Motrin/Advil), naproxen (Aleve), other non-steroidal anti-inflammatories (NSAIDS), vitamin E (multivitamin is OK), ginkgo biloba, garlic (tablets), and ginseng. These medications can thin the blood and create excessive bleeding. Tylenol is safe and may be taken anytime up to the day of surgery. St. John’s wort should also be avoided for 2 weeks prior to surgery because of possible interactions with anesthesia medications. If you take the blood thinner Coumadin, please discuss discontinuation of this medication with your surgeon.

If you smoke, it is critical that you stop smoking for at least three weeks prior to surgery and at least four weeks after surgery. Smoking can contribute to scarring, poor healing, and failure of the operation. Your primary care physician can direct you to resources for smoking cessation. Finally, it is important to inform your primary care physician that you are planning to have sinus surgery. Your primary care physician can help to clear you medically for surgery. Most of the necessary preoperative testing will be performed at Stanford on the day of your preoperative visit, but occasionally we will request old records from your primary care physician. We will make every effort to keep your primary care physician informed regarding your medical status both before and after your surgery.

During Surgery: In most cases, you will receive general anesthesia for your surgery, which means you will be asleep for the entire procedure. However, if you have a preference for local anesthesia, please let your doctor know, as this may also be an option in some cases. After your surgery has been completed, you will spend about one hour in the recovery room, followed by an additional recovery period of 1-2 hours in the second stage recovery unit. Most patients feel well enough to go home the day of surgery. You will most likely go home without nasal packing.

After Surgery: You can expect mild bleeding for 1-2 days after surgery and a general sense of fatigue for 1-2 weeks after surgery. In general, pain can be successfully controlled with narcotic or non-narcotic medications. For more details about postoperative care, please see the separate guide, “Postoperative Care Instructions.” You will have a series of postoperative visits that are critical for a successful outcome. At each visit your doctor will perform a procedure called nasal endoscopy to check how the sinuses are healing. An additional procedure called debridement may be necessary in order to clean blood from the sinuses and prevent early scar tissue formation. (Please note that these procedures are not included in the surgical charge and thus are billed separately.) Your visit schedule will usually consist of 3 visits over the first 6 weeks. Thereafter, your visits will be spaced a few months apart, depending on how well your sinuses are healing.

Risks of Surgery

As with any surgical procedure, endoscopic sinus surgery has associated risks. Although the chance of a complication occurring are very small, it is important that you understand the potential complications and ask your surgeon about any concerns you may have.

• Bleeding: Most sinus surgery involves some degree of blood loss, which is generally well tolerated by the patient. However, on occasion, significant bleeding may require termination of the procedure. Although most patients do not require nasal packing, a few patients will require a small nasal pack or tissue spacer to be removed after one week. Blood transfusion is rarely necessary and is given only in an emergency.
• Recurrence of disease: Although endoscopic sinus surgery provides significant symptomatic benefits for the vast majority of patients, surgery is not a cure for sinusitis. Therefore, you can expect to continue with your sinus medications even after successful sinus surgery, although in general your requirements for such medications should be lessened. In some instances, additional “touch-up” or revision surgery may be necessary to optimize your surgical outcome.
• Spinal fluid leak: Because the sinuses are located near the brain, there is a rare chance of creating a leak of spinal fluid (the fluid lining the brain) or injuring the brain. Should the rare complication of a spinal fluid leak occur, it may create a potential pathway for infection, which could result in meningitis. If a spinal fluid leak were to occur, it would require surgical closure and hospitalization.
• Visual problems: Visual loss has been reported after sinus surgery due to injury to the eye or optic nerve. The potential for recovery in such cases is not good. Fortunately, such a complication is extremely rare. Injury to the eye muscles may result in double vision. Persistent tearing of the eye is another possible complication. Tearing problems usually resolve on their own but occasionally require additional surgery.
• Other risks: Other uncommon risks of surgery include alteration of sense of smell or taste, persistence and/or worsening of sinus symptoms and facial pain, change in the resonance or quality of the voice, and swelling or bruising of the area around the eye.

Restrictions during postoperative recovery period

For the first week following surgery, you should not blow your nose. In addition, you should not bend, strain, or lift more than 20 lbs. during the first week. Light walking and regular household activities are acceptable anytime after surgery. You may resume exercise at 50% intensity after one week and at full intensity after two weeks. You should plan on taking one week off from work and ideally have a half-day planned for your first day back.

Conclusion

A brief treatment known as septoplasty is required to fix a patient’s deviated septum, or crooked nasal septum, during surgery. Dissolvable stitches that are concealed in the nasal region are used during this surgery, which is carried out through a tiny hidden incision. There are extra dangers involved in the procedure if you need septoplasty. The main dangers are bleeding or infection near the septum, numbness in the front teeth, a hole through the septum (septal perforation), leakage of brain fluid, or a Septal deviation recurrence. The likelihood that such events may change the nose’s outward appearance is extremely low.