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Double lateral osteotomy in rhinoplasty.

Double lateral osteotomy has proved to be useful in the management of broad, thick, and heavy maxillary processes. The technique of performing two lateral ostotomies and the indications for its application are described. The results obtained from cadaver dissection and clinical experience with this technique are discussed.

Humans↗

An approach to aesthetic rhinoplasty in the non-caucasian nose.

The problem of augmenting the nasal dorsum and columella in the exaggerated Negroid or Oriental nose is presented. Augmentation of the nasal dorsum is routinely performed using polyamide mesh. The lengthening and lowering of the short and sometimes retracted columella and narrowing of the alar bases is performed by making a columellar splitting incision and extending it along the alar sills. A septal cartilage graft is sewn into the new columellar space, and the alar sills are advanced into the columella, thereby lengthening the columella and changing the axis of the nares. The columellar advancement is done after the dorsal implantation is performed, and the projection of the tip is advanced to whatever amount necessary to aesthetically match the dorsal profile line.

Adult↗

Silastic alar-columellar prosthesis in conjunction with rhinoplasty.

A Silastic alar-columellar prosthesis, designed by Lawrence Birnbaum, MD, is commercially available. Used as an implant in the columella and overlying the domes and lateral crura of the alar cartilages, it can aid in obtaining and maintaining tip projection and in reshaping the lobule. Its use is limited and should be reserved only for special cases, ie, those patients in whom there is substantial loss of nasal tip projection, or notable asymmetry, or absent alar cartilages and in patients in whom there is a lack of autogenous grafting material. I have used this prosthesis in 19 patients and have found it to be a valuable adjunct.

Biocompatible Materials↗

Dome-splitting technique in rhinoplasty with overlay of lateral crura.

While the majority of nasal tips respond to the more conventional and conservative surgical approaches, there are those patients who require a more radical approach. The prerequisites for the ideal nasal tip are outlined. The indications for the proposed technique are enumerated and the dome-splitting overlapping technique is described. The advantages and disadvantages are discussed and photographic results are presented.

Esthetics↗

Rhinoplasty surgery.

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Adrenal Cortex Hormones↗