Dr. Fusco’s Closed Rhinoplasty Philosophy

There are two main ways in which surgery can be performed, and this very lack of information can easily lead a future rhinoplasty patient into having a more traumatic and unnecessary surgery if she doesn’t do enough homework.

Dr Fusco has been performing closed rhinoplasty, in his practice for the past 35 years, and worries that soon, it is going to become extinct. “Closed rhinoplasty”, commonly referred to as “finesse” rhinoplasty, is a unique surgery whereby corrections and enhancements of the nose are made internally through the nostrils, avoid the need to inflict a scar at the bottom of the nose.

Enhancing and beautifying the nose without visible scarring is the premise upon which Dr. Fusco practices rhinoplasty surgery. Closed rhinoplasty surgery is also ideal for the majority of patients having cosmetic nasal surgery for the first time since there is much decreased post operative swelling, bruising, and pain. Most patients recover very quickly, which is important, because statistically speaking these patients are young, energetic, and very social. This enables them to perform activities of daily living usually on post operative day two, and return to social events by day seven. Upon removal of the cast, most patients don’t show evidence of having had surgery and this accommodates the needs for busy patients who need to return to work, school, and can’t take extended time away from their responsibilities. Scarless surgery coupled with decreased healing times, are a few of the many advantages of having closed nasal surgery.

Dr Fusco understands that most educated patients, given the option, would unequivocally choose the closed approach one hundred percent of the time. If given the opportunity, most women would not accept scarring, prolonged swelling, and bruising if they were told other options were available.

Rhinoplasty is about finesse, NOT change. During consultation, he reviews the nose in 9 categories:
1 Breathing
2 Septum
3 Internal Nasal Valves
4 Turbinates
5 Length of nose
6 Tip configuration
7 Projection
8 Width and asymmetry of nasal bones
9 Width and contour of nostrils

Body Contour Philosohpy

In hot climates, especially in urban centers close to the sea, people are used to wearing light and revealing clothing, preventing the camouflage of large and heavy breasts. Patients with breast hypertrophy often report, in addition to physical discomfort, a process of social isolation.
Women with very large breasts are surgically treated for reduction, in which the excess tissue is removed, providing a contour to the breasts which is aesthetically satisfactory, whilst preserving the functional aspect. All breast tissue removed goes through careful histological examination.
Very small breasts (mammary hypoplasia) occur when the volume of the breasts is significantly reduced. The correction of underdeveloped breasts is a fundamental factor for a woman’s intimate wellness, emphasizing her femininity and sensuality.
The best breast enlargement method is prosthesis placement (breast implants). The most important aspects to be discussed with the patient are desired breast volume, implant type and access route for prosthesis placement.
During the first weeks after the surgery, the patient must not do vigorous exercise or be excessively exposed to the sun. During the postoperative period, it is essential that the patient avoids raising her arms or carrying weight.


The abdomen, as a holder of vital organ systems and as sexual activity support framework, is a fragment of our psychic and body history. During pregnancy, hormonal changes and abdomen distention can cause body structure imbalance.
When indicated, abdominoplasty – following the Angelo Fusco Clinic – aims to correct cosmetic and (above all) functional deformities caused by the diastasis (widening / separation) of the rectus-abdominis muscle. The scar resulting from this surgery will follow the power lines located in the lower abdomen, making them less noticeable.
Currently, with the increased incidence of obesity and the consequent increase in bariatric surgery (surgery for stomach reduction), patients seek plastic surgeons in order to remove excess skin resulting from great weight loss. The surgical procedure indicated in such cases contemplates more tissue reduction than fat extraction.

Body contour surgery gained a major ally in the late 70′s with the rise of liposuction and its numerous indications to correct lipodystrophy areas for which there used to be few surgical resources. Lipodystrophies named trochanteric lipodystrophy (riding breeches) that in the past used to be corrected by extreme techniques – are now less frequent, since a large part of the deformities caused by localized fat are now corrected by liposuction. However, in extreme cases of post-obesity weight loss, some surgical techniques such as the Pitanguy riding breeches technique are still indicated.


Liposuction – sometimes called Liposculpture – is mainly indicated for the removal of localized fat. The correction of fat accumulated in body parts (previously inaccessible or accessible only through undesirable incisions) achieved, with liposuction, an important chapter in plastic surgery when properly indicated.
When properly indicated liposuction represents an important achievement. The areas and the amount to be suctioned vary in each case –all patients must undergo medical examination, after which they will receive the advice of the surgeon and his medical staff regarding the indicated procedure.


Beauty is a universal concept, essentially related to the search for harmony as a mean achieving personal wellness. Due to its exposure and expressiveness, the face is often the focus of aging-inherent changes.
Facial rejuvenation surgery is aimed at enabling a patient to naturally accept his biological age, softening the transition between full adulthood and a more mature life stage.
The angelo fusco technique for treating facial aging allows repositioning of tissues following a line contrary to aging. This technique, called round lifting, aims to provide facial balance without the surgery stigma. The objective is to achieve a natural look, and this surgery is often associated with blepharoplasty, surgery of the cervical region or of the frontal region.

Ear Deformation

Prominent ears: beyond the aesthetic dissatisfaction, this deformity often causes emotional disturbances. People whose ears are prominent are frequent victims of bullying, called “Dumbo” and other derogatory names. Surgical correction is made using the antihelix (which was not congenitally formed) is recreated, giving a normal aspect to the ears.

During the postoperative recovery period, the patient must not do vigorous exercise or be exposed to the sun. After surgery, the patient is instructed to wear a bandage compressor – like a ballerina headband for women or tennis headband for men.


Excess tissue that gives a feminine aspect to the male chest is surgically removed through an areolar or trans-areolar incision. The procedure is complemented, when necessary, by liposuction. In cases of pseudo-gynecomastia, or when excessive fat is the main cause of the deformity, liposuction only may be applied.
Gynecomastia should not be seen exclusively from a structural angle; the deformity is often accompanied by psychosocial disorders.

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