Dr. Robert A. Guida has repeatedly been listed in the Castle Connolly Guide of Best Doctors recognizing him as one of “the best doctors in New York,” New York Magazine’s feature on top “Beauty Doctors”in New York City, and in New York Magazine’s Best Doctor Issue. He has been practicing rhinology (the study of the nose) and facial plastic and reconstructive surgery in New York since 1990. Dr. Guida has unique and extensive training in both functional and cosmetic nose surgery. He is double board certified in Facial Plastic and Reconstructive Surgery as well as Otolaryngology-Head and Neck Surgery. Because of his unique training, Dr. Guida is highly skilled in surgical treatment of all aspects of nasal sinus disease, functional nasal problems, surgery for nasal obstruction, cosmetic rhinoplasty, repairing broken noses, and complex revision rhinoplasty.

1. ROBERT A. GUIDA M.D., P.C.
RHINOLOGY:
Cosmetic and Functional Nose Surgery
www.drguida.com

2. “ My mission is to
truly understand
what my patients’
goals are and then
educate them about
realistic and optimal
”
treatment options.

3. ABOUT DR. GUIDA
Dr. Robert A. Guida has repeatedly been listed in the Castle Connolly
Guide of Best Doctors recognizing him as one of “the best doctors in
New York,” New York Magazine’s feature on top “Beauty Doctors”in
New York City, and in New York Magazine’s Best Doctor Issue. He
has been practicing rhinology (the study of the nose) and facial plastic
and reconstructive surgery in New York since 1990.
Dr. Guida has unique and extensive training in both functional
and cosmetic nose surgery. He is double board certified in Facial
Plastic and Reconstructive Surgery as well as Otolaryngology-Head
and Neck Surgery. Because of his unique training, Dr. Guida is
highly skilled in surgical treatment of all aspects of nasal sinus
disease, functional nasal problems, surgery for nasal obstruction,
cosmetic rhinoplasty, repairing broken noses, and complex revision
rhinoplasty.

4. INTERESTING FACT:
More than 37 million Americans suffer from at least
one episode of acute sinusitis each year.
DEVIATED SEPTUM
Above is a photograph of real time image guided surgery, using a patient’s CT scan
synchronized with live video.

5. TREATMENT OF SINUSITIS
Chronic sinusitis is a functional problem of the nose, which affects
a large portion of the population. Often times it is also related
to allergic rhinitis. Typically, people with chronic sinusitis have
recurrent sinus infections and head colds several times a year
over a few years. Antibiotic treatment will typically improve the
situation initially. However, shortly after stopping the antibiotic
therapy the infection will recur. Symptoms include headaches,
facial pain, nasal congestion, nasal drainage, postnasal drip, and
occasional visual changes. Prior to the use of antibiotics, sinusitis
was life threatening potentially causing meningitis and even death.
Endoscopic sinus surgery, computerized image guided surgery, and
high-resolution CT scans have revolutionized the surgical treatment
of sinus disease. Using a small rigid endoscope connected to a large
video monitor, this surgery can be done under direct, magnified
vision yielding specific and positive results. New image-guided
technology allows a CT scan to be used as a real time “road map”
during the procedure, allowing for precise accuracy during the oper-
ation. The operation can be done under twilight or general anesthe-
sia and there generally is no nasal packing postoperatively. Patients
typically require several days off of work after this procedure for
recovery.

6. DEVIATED
NASAL SEPTUM
INFERIOR
TURBINATE
HYPERTROPHY
“I cannot breathe through my nose. Can that be fixed at the same time
that I am having surgery to make my nose look better? ”
Frequently, cosmetic nasal surgery is done simultaneously with functional nasal
surgery and sinus surgery. The most common functional complaints patients have
regarding their nose is that they cannot breathe through it or that they suffer from
frequent sinus infections. Surgical problems causing nasal obstruction that are easily
corrected related to the nose include a deviated and/or fractured nasal septum, nasal
polyps, a broken nose, chronic sinus infections, or enlarged turbinates. Dr. Guida can
determine the cause of the nasal obstruction by both a physical exam as well as a CT
scan of the nose and paranasal sinuses. This will give Dr. Guida detailed information
and allow him to provide you with a clear assessment of your options and chances
for improving your nasal obstruction.

7. TREATMENT OF NASAL OBSTRUCTION
Fixing a deviated nasal septum involves one small incision inside the nose.
Fixing this problem by itself generally does not cause any external bruising
and there is no need for a nasal splint following the operation. Dr. Guida
rarely packs the nose following the operation, as he uses dissolvable sutures to
hold the structures in place afterwards. Typically, the patient can breathe well
initially in the recovery room, but within several hours after the operation, the
nasal lining swells and it could take approximately 1-3 weeks for the swelling
to go away. Frequently, a deviated nasal septum can affect the external shape.
Therefore, it is often straightened during cosmetic rhinoplastly.
BEFORE AFTER BEFORE AFTER

8. REVISION RHINOPLASTY
Revision rhinoplasty is a complex operation that must always be performed with
much thought and care. Dr. Guida has successfully performed revision rhinoplasty
surgery on a large number of patients from around the world. Often, patients
seeking revision rhinoplasty have a combination of cosmetic and functional
concerns, requiring a surgeon highly skilled in both types of surgery. Dr. Guida’s
unique double board certification in both Facial Plastic Surgery as well as Otolar-
yngology – Head and Neck Surgery, as well as over twenty years of experience,
makes him extremely qualified and proficient at performing revision rhinoplasty
surgery. Cosmetically, there often is an unnatural appearance to the nose, ranging
from tip asymmetry to a “scooped-out” nasal bridge. There may be nasal obstruc-
tion from a deviated nasal septum, open roof deformity, chronic sinusitis, or a
septal perforation. Dr. Guida can assess these issues and determine the most
appropriate treatment plan for a successful outcome.
BEFORE AFTER BEFORE AFTER

9. BEFORE
COSMETIC NOSE SURGERY
Rhinoplasty, commonly referred to as a “nose job”, is an operation
that cosmetically improves the appearance of the nose. Cosmetic
problems of the nose can be either genetic or acquired, perhaps due to
an accident, resulting in a fractured nose. The most common cosmetic
problems encountered are noses that are too large relative to the rest
of the facial features, noses with prominent bumps on the bridge,
noses with wide nasal bridge, noses that are very crooked due to a
fractured nasal bones, or a congenital deviated nasal septum.
AFTER
Can I get an idea of what my new nose will look like before
actually having surgery?
Because of the individualized concerns each patient has with rhino-
plasty surgery, Dr. Guida prefers using digital computer imaging to
analyze the patients facial and nasal proportions prior to surgery.
Altering the shape of the nost on the computer allows for a more
interactive discussion between Dr. Guida and the poatient in terms
of final outcome of surgery.
This patient had a
deviated septum, a
hanging columella and
a broken nose repaired.
Dr. Guida’s work
provided a more

10. ETHNIC RHINOPLASTY
Over the past several decades ethnic rhinoplasty, performed on Hispanic, Asian, African Amer-
ican, and Middle Eastern patients, has become increasingly commonplace. This type of surgery
focuses on maintaining balance between cosmetic alterations and ethnic characteristics to
achieve a natural and cosmetically attractive appearance. Commonly, patients seek more refine-
ment of a bulbous nasal tip and narrow a wide nasal base, nostrils, and nasal bridge. Dr. Guida
has succes fully operated on hundreds of patients from around the world for these conditions
and is highly skilled at this type of surgery. With preoperative computer imaging and carefully
listening to patients concerns, he can help the patient reach their cosmetic and functional goals.
BEFORE AFTER BEFORE AFTER
NON-SURGICAL RHINOPLASTY
There are non-surgical approaches to cosmetically improving one’s nose that are proven to be
highly successful. In appropriately selected cases, Dr. Guida can use injectable fillers to create
both permanent (Silikon-1000) and temporary (Radiesse. Juvaderm, and Restylane) corrections.
Temporary corrections may last as long as several months to a year with no need for surgery.
These procedures can resolve imperfections in the nasal bridge, tip, and nostrils in as little as
one office visit, requiring no anesthesia and having no down time. Injectables can camouflage
a small bump, straighten a crooked appearance, bring balance to asymmetry, widen a pinched
tip, and lower excessively high nostrils. An experienced nasal surgeon is essential in obtaining
optimal results. Dr. Guida has a proven success rate for this type of procedure.
�

11. OTHER NASAL SURGERY
SKIN CANCER OR TRAUMA
Over a million new cases of skin cancer are diagnosed and treated each
year in the United States. 80% of these cancers are on the face or head
and neck region. Skin cancer removal of nasal tissue requires careful
cosmetic reconstruction to achieve minimal deformity and a natural
aesthetic result. Dr. Guida has extensive experience in facial and nasal
reconstruction following excision of skin cancers or as a result of facial
trauma. He has published numerous articles and lectured extensively
on the various types of facial reconstructive techniques. Often after the
cancer excision, the result is a significant soft tissue and structural
defects. Dr. Guida will choose the most appropriate technique, from
skin grafting to simple or complex facial flaps, to most appropriately
reconstruct these defects.

12. For all further inquires please
contact our office to schedule a
consultation with Dr. Guida.
CONTACT INFORMATION
Robert A. Guida, M.D., P.C.
1175 Park Avenue, Suite 1-B
New York, NY 10128
Appointments: 212-871-0900
Office Fax: 212-871-0909
Web: www.drguida.com
Email: info@drguida.com