Ellie Rosenfeld, DDS, MD, FACS

Ellie Rosenfeld, DDS, MD, FACS Board Certified Oral and Maxillofacial Surgeon

04/01/2026

The main reason I stand on the left side to take out number 17 is my height. I am 5 foot 2.5”. With my shoes I’m 5’ 3”.

As I’ve said many times, I’m just not tall enough to see down there. So I always switch to the left side to take out tooth number 17.

But I have discovered an additional benefit to standing on the left side. Because I can keep the patient’s head in the neutral position, all of the water from my drill pools in the vestibule, and none of it goes down the airway.

So while I could theoretically stand on a stool and stay on the right side, I actually really like switching. It takes 5 seconds. When I built my office, I designed my operatories to have enough room either in front of or behind the patient to facilitate switching.

I encourage all my residents to try switching and see the benefits and decide for yourself!

03/26/2026

I am a righty, but I switch to the left side for just about every single lower left molar.

I guess it’s just that the chairs don’t go low enough for me. I am 5 foot 2 1/2. And no matter what, even though my hands can technically reach the tooth, my torso isn’t long enough to see properly. Switching sides has changed my life.

you absolutely cannot beat the visibility that you get from standing on the left side. I know many of you switched to the left side to do a coronectomy on tooth number 17. So this is really no different.

Hand placement, however, can be challenging. But I have adapted. In this video, I’m showing how I have adapted my hands to facilitate the extraction.

My left hand is holding the Minnesota and supporting the jaw. My right hand is holding the drill and it’s kind of over the patient’s head. at first, it was awkward, but so is everything at first, right? You can train your hands to get good at anything.

it’s similar in orthognathic surgery. I’ve gotten used to standing on the left side so that my resident first assisting me can have the easier side if they are a righty. And now, standing on the left side for orthognathic cases is just easier for me.

We are highly adaptable creatures. It’s really all a matter of training yourself.

03/12/2026

It’s always 10/10. Always.

Can you relate?

03/05/2026

Extracting premolars absolutely has its place in the arsenal.

But please consider underlying skeletal discrepancies and facial esthetics before jumping to this last resort!!

Because if the patient actually has a skeletal issue, and they really need jaw surgery, the effects of removing the wrong premolars and retracting the anterior teeth can have disastrous effects on both facial esthetics and airway.

I have seen too many heartbreaking nightmare stories.

If you’re not sure, just call me. Seriously. I’m happy to guide you through the decision making process.

02/26/2026

All humor is based on a modicum of truth, right?

02/19/2026

Impactful words I learned during residency that stuck forever.

All of the current literature today recommends continuing anticoagulants and NOT stopping them for extractions.

So why are there dentists still asking cardiologists to stop blood thinners? Why do patients come to me for an extraction and say their cardiologist said it’s ok to stop the anticoagulant?

We need to follow the evidence and stop being stuck in the Dark Ages for all eternity.

Disclaimer: Not medical advice. Education and entertainment only.

bloodthinner dentalwisdom toothextraction dentaleducation

02/12/2026

Genioglossus advancement is one of the most effective ways to expand the airway when the tongue base is contributing to obstruction. The genioglossus muscle attaches to the genial tubercles on the lingual surface of the mandible, so bringing that bone segment forward mechanically advances the tongue as well.

When a patient needs airway improvement but would not look good with additional chin projection, genioglossus advancement becomes an important option. Instead of advancing the entire chin, I remove a small rectangular segment of bone in the midline that includes the genial tubercles. I plan this virtually of course, using custom surgical guides that I design so that I make sure to capture the genial tubercles. I draw this segment forward, fix it into its new position with K-wires so that the lingual cortex of the segment aligns with the facial cortex of the mandible, and then contour the remaining bone so the surface is smooth. This can advance the tongue base by up to 10 mm without creating unwanted changes in facial aesthetics.

This procedure is often performed as part of a broader treatment plan for obstructive sleep apnea or upper airway resistance, and it can be combined with other skeletal or soft tissue interventions depending on the patient’s anatomy and goals. My goal is always to choose the technique that will meaningfully improve airway function while keeping the patient’s facial balance intact.

If you want to see more airway surgery breakdowns or have questions about when I choose genioglossus advancement over other procedures, feel free to ask.

Disclaimer: Not medical advice. Educational content only.

02/05/2026

We are all a little bit tweakers right?! 😬 Now that I put it all out there it seems like a lot!!

I started with some innocent Botox in 2015 or so, fillers in my tear troughs and lips a bit after, and the reel tells the rest. Of course I’ve kept up both over the years. I mostly injected myself at first, because it was fun to experiment and I could go at my own pace, and sculpt gradually. But now that I’m getting older, I let do it because let’s face it a 40’s and beyond face is just more technique sensitive.

One thing I did do is experiment with chin filler on myself to see what I would look like with an augmented chin before moving forward with genioplasty. That was very helpful.

What I’ve left out of the reel is my skincare by ,
As well as hydrafacials at

Every 12-16 weeks I go to for microneedling with PRF (aka vampire facial).

One big difference I notice is in my eyes. In 2014, I was a very young new attending, with a little chip on my shoulder and lots to prove. I was not super confident, being surrounded in a male dominated field, in a male dominated group practice. Almost 12 years later, I have over a decade of experience behind me, and I have found myself as a surgeon. So despite looking older, I see in my own eyes the increased confidence and comfort with myself that comes with all of that.

buccalfatremoval genioplasty

01/29/2026

Please share this reel to overcome the surgery shadow ban!! How else can we provide education on here?

Ok so the cowhorn is a freaking genius instrument.
And if you don’t love using it, you’re probably using it wrong. Once you learn how to use it properly, it unlocks another level of surgical skill.

People who “don’t like” the cowhorn almost always:
• under-squeeze
• under-move
• choose terrible cases

In this reel I share 5 key principles of cowhorn use that will change your life.
1. Case selection
Generally patients younger than 60. Lower molars with a visible furcation. Preferably no endo. Some coronal integrity.

2. Complete anesthesia
The patient must be numb, and they also have to be able to tolerate pressure sensation. If they can’t tolerate pressure, this is not the instrument for this case.

3. Accurate placement
You must get the beaks of the claw into the furcation, both buccal and lingual. If you’re not in the furcation, you’re just squeezing enamel and accomplishing nothing.

4. SQUEEZE
As hard as you can. I hold the ends of the forceps to get better squeeze with less hand pressure. This is why OMFS have jacked forearms. And once you squeeze, don’t let up until the tooth is out. The squeeze is continuous.

5. THE MOVE
ALL THE WAY UP. ALL THE WAY DOWN.
I see even OMFS residents do this little sissy up-down movement. that’s just not going to cut it. The forceps must touch the upper teeth, then go all the way down and touch the lower teeth.
I notice residents don’t like to go all the way down to the lower teeth, but that is the most important part. The beaks are literally pushing their way into the furcation, causing displacement of the tooth.
About every 5 full up-downs, add a small bucco-lingual wiggle to help loosen the tooth from the PDL.
The entire time, never let up your squeeze.

Remember every single one of these principles, and the cowhorn will not fail you.

Disclaimer: not medical advice blah blah blah so I don’t get in trouble.

01/22/2026

I think that mostly OMFS will appreciate this. But I know that all dentists will get the last two!

Things patients do at the oral surgeons that make us laugh:

1. Lie down in the chair that clearly has a back for sitting upright: I think this is because they are used to lying supine at the dentist maybe?

2. The head rest: They always seem to want to perch the back of their head on the edge of the headrest, instead of resting it in the center. This one I cannot explain.

3. Straddling the chair of the CBCT machine facing inward: This one I have no explanation. But patients do this one ALL THE TIME. Docs, check with your assistants who take the CBCTs, guaranteed they see this.

4. Chewing the bite block like it’s gum: I’m sure this happens with all dentists/specialists.

5. Spitting out the contents of their mouth all over themselves when we put the suction in their mouth. We all know this one. Like they get allergic to their own saliva.

Did I leave anything out?

01/15/2026

I spent my twenties doing 4 years of dental school and then a 6 year OMFS residency while raising three young children.

I was constantly studying, operating, on call, pregnant, postpartum, exhausted. Most people my age were out enjoying their freedom, and I was trying to keep my head above water while building both a career and a family at the same time.

I was physically depleted from years of broken sleep, pregnancies, and babies. I was mentally stretched from trying to do everything well and not fail at any of it. I never took a day off, lest someone should make a comment about me as a mother having dual responsibilities. I felt behind the ball and exhausted all the time.

My thirties were different, but not easier. My kids were in middle school and high school, and I was working in private practice. They no longer needed diapers, but they needed help with homework, carpools, emotional support, and constant presence. At the same time, I was still trying to establish myself professionally. The exhaustion shifted from physical to mental.

Now I am in my forties. My kids are in their late teens and twenties. They are mostly independent and no longer need me every minute. For the first time, I have the space to explore, travel, move, and enjoy parts of life that many people experience in their twenties.

Many of the friends who were partying back then are now raising babies.

There is no easier path. There is only a different order.

It is hard either way. I love how I did it. I believe it is possible to build both a career and a family, but only if you are willing to work extremely hard and defer gratification in one way or another.

I did not miss my twenties. I just postponed them.

How did you do it?

01/08/2026

When I first posted my lower third incision design, I got about 30 messages telling me that they use the method and it is the best. I guess I struck a nerve.

I love that incision, it is a totally valid method. Jason uses a classic sulcular approach with a DB release, maybe lifts a little distolingual tissue. That’s fine. I learned that way first and did it for years.

But over time, I’ve adopted a variation that, in my experience, keeps patients more comfortable post-op. I spare the papilla between the second and first molar, cutting straight from sulcus to sulcus. I don’t elevate the lingual tissue at all. And when I close, a single posterior suture cinches everything down — and since the papilla was never elevated, it doesn’t flap around post op, and I don’t have to put another suture there.

And I showed this incision on here because I think it’s great and I wanted to share it with those who appreciate being exposed to different techniques.

No beef here, guys. They’re both great techniques. I always tell my residents- The best surgeons get exposed to as many techniques as possible, try them all, and choose what works for their patients and their workflow. The important thing is to have good reasons for everything you do and to not be dogmatic about anything. If you are open to continue learning your whole career, you will just keep getting better.

But I am willing to admit that Jason’s surgical footage makes mine look like it was filmed in the dark ages. 🎥🔥



Do you take the papilla in your incision/flap?

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