Facial Plastic & Reconstructive Surgery

About Dr. Clark

Dr. David Clark is an Otolaryngologist and Facial Plastic Surgeon who has been practicing since 1988. He completed medical school and residency at the University of Virginia in Charlottesville. After completing his residency in Otolaryngology-Head and Neck Surgery in 1988, he served as Professor of Surgery at the National Naval Medical Center in Bethesda, Maryland from 1988 to 1991. He then completed a fellowship in Facial Plastic and Reconstructive Surgery with Dr. Richard Farrior (Tampa, FL), and joined Capitol Ear, Nose, and Throat in 1992. He is double Board Certified in Otolaryngology-Head and Neck Surgery, and in Facial Plastic and Reconstructive Surgery.

Dr. Clark works extensively with prominent dermatologists in our area, and frequently repairs facial defects after skin cancer removal. He has performed literally thousands of facial cosmetic and reconstructive procedures during his career. Dr. Clark is one of North Carolina's most experienced surgeons in repair of facial defects after skin cancer removal. His dual Board Certification means that Dr. Clark always keeps both function and the aesthetic result in mind.

Services Offered

Post-Traumatic

Dr. Clark performs repair of post-traumatic injuries including nasal fractures, orbital fractures and scar revisions.

Nasal valve Repairs performed by Dr. Clark

Reconstructive

Dr. Clark frequently performs repair of facial defects following removal of skin cancer. Many of these patients have recently undergone Mohs surgery, a specialized technique for removal of facial/skin malignancies. Common procedures include flaps and grafts.

A Bi-Lobe Flap is often used to repair defects of the nose, especially when the defect is less than 1.5 cm (3/4") in diameter. Nasal skin is rearranged in a geometrical pattern to fill in the hole after cancer removal. The skin texture and color match is excellent, since the skin "brought in" for repair is native nasal skin.

Nasolabial Flaps are frequently used to repair defects of the nostril and nasal tip. In this procedure, skin is transplanted from the cheek to the nose in two outpatient procedures. Cheek skin has a similar color and texture to nasal skin, and the donor site scar can be hidden in a naturally occurring cheek fold.

A Forehead Flap is generally reserved for more extensive defects of the nose, or in cases where grafting is not an option. Analogous to the nasolabial flap, this requires two outpatient procedures separated by three weeks. Cartilage grafting may be done in conjunction with this procedure if necessary.

Full Thickness Skin Grafting is the most straight forward procedure for repair of facial defects. Skin is removed from the lower neck (or behind the ear), and the donor site closed. The skin is then cut to the appropriate shape and sewn in to the defect. This is usually the least invasive option, but may not always provide the skin color and thickness match that flaps typically offer. Dr. Clark will always be happy to counsel you extensively regarding which options might be best for you.

Cosmetic Procedures

Rhinoplasty

(About the operation) The nose is the most defining characteristic of the face, and a small alteration can make a big difference. In rhinoplasty, the bone and cartilage of the nose are carefully shaped to provide a pleasing appearance. Dr. Clark pays particular attention to both function and aesthetics, and improvement in appearance and breathing is always his goal. He also performs revision rhinoplasty procedures.

Is It Right For You? Preoperative rhinoplasty patients should carefully consider what changes they desire from the operation. The more specific you can be regarding what you like (and don't like), the better Dr. Clark can advise you about postoperative expectations. Frequently, the nose is made smaller, the bone and cartilage straightened, and/or the tip is narrowed to enhance appearance.

Having cosmetic nasal surgery is a big decision. After careful examination, Dr. Clark will counsel you extensively and provide various surgical options. If the procedure is right for you, he will advise you what to expect in the days and weeks following the surgery. After the operation, patients are seen for several months to monitor their progress and document healing.

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Blepharoplasty (Eyelids)

In blepharoplasty, redundant skin is removed from the upper and/or lower lids to invigorate the appearance of the eyes. In certain cases, a small portion of fat may be removed or repositioned as well. Incisions are hidden in pre-existing creases or adjacent to lashes to minimize scarring. In patients with a visual field defect (loss of a portion of the visual field secondary to redundant upper lid skin), insurance may pay for upper lid surgery. When drooping of the brow is involved, a brow lift can also be performed.

Is it right for you? In the appropriate setting, blepharoplasty can make the eyes look younger and more relaxed. After eyelid surgery, patients are often told that they look "more rested". It will usually not address "crow's feet" or other facial wrinkles. Dr. Clark will be happy to counsel you regarding postoperative expectations.

Otoplasty

In otoplasty, protruding ears are moved closer to the head for a more natural appearance. Redundant cartilage is removed and permanent sutures hold the ears in place. Incisions are made behind the ears and are thus hidden from view. In children, the procedure is performed under general anesthesia, while adults often have this performed under local anesthetic in the office.

Is it right for you? Otoplasty can make a dramatic change in one's appearance. It provides the most "immediate result" of any facial cosmetic procedure.

Chin Implants

Chin implants are often placed to address a weak or receding chin. Although frequently performed in conjunction with rhinoplasty under general anesthesia, it may be performed as a stand alone procedure in the office with only local anesthesia or mild sedation.

Dermabrasion

Dermabrasion is a form of mechanical exfoliation that removes the outer layer of the skin—the epidermis—and a portion of the thickest layer, the dermis. After the procedure, new skin cells are regenerated in a much smoother manner. Dermabrasion is often used as a part of scar revision after reconstructive procedures, and also has a place in the treatment of acne scarring. Most commonly, dermabrasion can be performed in the office under local anesthesia.

Also visit this helpful and educational web site from the American Academy of Facial Plastic and Reconstructive Surgery. www.aafprs.org

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