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Psychiatric evaluation of patients seeking rhinoplasty.

The number of people requesting cosmetic surgery has been increasing. Both objective and subjective motivational factors are involved. Since the face is the most important physical representative of our emotions and the nose isthe most prominent part of the face, not infrequently subconscious and unconscious personality factors are equated with some real or imaginary anatomical defect of the nose or face. Most commonly inadequacy feelings are involved in individuals with predominantly subjective complaints and are often intimately involved in the indivudual's sexuality and "identity." The nose may become a scapegoat for these confused feelings. Three categories of patients whose emotional state and personality should be recognized are: the hysterical personality, the depressed menopausal female, and the paranoid personality. Motivational patterns may be divided into two groups: (1) external motivations (including the need to please others), career or social ambitions, and the need to avoid cultural conflicts (e.g. avoidance of alien stereotype) and (2) internal motivation, including paranoid ideation, long standing feelings of deficiency in one's physical appearance, general inadequacy or low self-esteem in one's worth or ability, resentment of aging, or actual lack of a special identity due to conflicting parental identification. In selecting a patient for thinoplasty, an evaluation of medical, sociocultural, psychological, and environmental factors should be considered.

Adult↗

Augmentation rhinoplasty.

The combination of grafts and skeletal maneuvers will usually yield a nose that is esthetic and functional. Subtleness is the key--the nose should neither be stark in appearance nor impart the sensation of rigidity to feel. Where multiple grafts are called for, they are preferably nonarticulated so as to give the sensation of natural "give" to the touch, and forbearance against trauma as in the native nose. Constructive and reconstructive tactics for the nose, while based in sound rhinoplastic and craniomaxillofacial protocols, often include judicious usage of augmentative materials and techniques. For both appearance and also for function, their use is most gratifying for the patient and for the clinician.

Biocompatible Materials↗

[Rhinoplasty of unilateral cleft lip].

OBJECTIVE: To investigate the technique for unilateral cleft lip nasal deformities. METHODS: Through the traditional columella margin incision, the alar cartilage and the lateral nasal cartilage were exposed. After the mucosa between the two cartilages was divided, a mucosa-cartilage flap was developed and anchored, moving the lateral crus upwardly and medially, correcting the nasal deformity. RESULTS: 52 cases of primary nasal deformities and 18 cases of secondary nasal deformities were corrected with this technique. Satisfactory results were achieved. CONCLUSION: This technique is recommendable, which is more likely to restore the physiological characters of the nose than the conventional technique.

Adolescent↗