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At least 1,279 records · Page 71Linked to original sources

Rhinoplasty: creating an aesthetic tip. A preliminary report.

A new approach for creating an anatomically aesthetic nasal tip is presented. It is based on extensive cadaver dissections which demonstrate that a convex domal segment plus a sharp domal segment-lateral crural drop-off are key determinants of a refined tip. This configuration can be achieved with sutures in a manner similar to creating the anthelical curl in an otoplasty. Two operative variations are presented. One achieves tip refinement with a limited increase in projection, while the other provides maximum projection. Currently, the technique is of value in bilateral cleft lip noses, posttraumatic deformities, certain secondary cases, and very selected primary aesthetic cases where tip refinement and projection are limited.

Adult↗

Non-caucasian rhinoplasty and adjunctive reduction cheiloplasty.

This article is based on 19 years of experience that includes more than 300 cases of reconstructive nasal surgery in non-Caucasians. The evolution of the author's surgical technique is presented, as influenced by long-term effects of various surgical maneuvers. The adjunctive reduction cheiloplasty is also discussed.

Black People↗

Rhinoplasty: nasal anatomy.

On the basis of over 100 fresh cadaver dissections as well as a review of nasal embryology and development, several important observations can be made regarding surgical anatomy of the nose. Within the bony vault, nasal profile modification consists of two distinct maneuvers: bony hump removal and modification of the nasofrontal groove area. The cartilaginous vault is in reality a unified, winged structure composed of septum and upper lateral cartilages. Within the nasal lobule, a continuous cartilaginous ring exists. The nose itself is covered by a superficial muscular aponenotic system.

Cartilage↗

Rhinoplasty.

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Humans↗

Rhinoplasty and the nasolabial area.

The nasolabial area is important to consider in achieving a satisfactory relationship between the nose and the other features of the face; this will result in a natural-looking nose. However, the importance of the entire nose on a particular face should be kept foremost in mind.

Face↗

Rhinoplasty. Ancillary procedures.

Assessing facial balance before attempting correction of nasal proportions is critical. Modifications of facial structures, which alter perception of the nose, even with seemingly minor disproportion, can do much to enhance final results. Many of these procedures are conceptually simple, rapidly executed, and overwhelmingly gratifying.

Adipose Tissue↗

The use of augmentation rhinoplasty techniques for the correction of the non-caucasian nose.

To refine, enlarge, and enhance the mestizo nose, it is necessary to augment the structural support. The authors report on a series of more than 3000 patients over the last 20 years, exploring the possibilities of autogenous graft for augmentation of the nose. Their series showed minimal resorption of the bone grafts, no loss of volume of the cartilage grafts, and satisfactory long-term results.

Adolescent↗

Secondary rhinoplasties and composite grafts.

We have discussed composite grafts and some of their uses in secondary rhinoplastic procedures, the donor sites, and methods of application as to the dynamics of the iatrogenic problems and large septal perforations. A technique for nasal tip revisions as well as a safer septoplasty surgery that we have used for some years has also been shown.

Cartilage↗

[A controversial procedure: rhinoplasty in children].

Confronted with nose malformations in children, surgeons experience at the same time a legitimate desire to rapidly attend to the altered anatomical structures, and a fear to aggravate the lesions existing initially by operating during a period of growth. Numerous animal experiments have not been conclusive as far as these two contradictory theses are concerned. In all cases, prudence remains mandatory, that is prudence towards the operational indications (important functional impairment), the date of the intervention (risk minimization with age), assessment of expected results (secondary malformations occurring even very late postoperatively).

Adolescent↗

The gull wing incision in cleft lip rhinoplasty.

The deficient anatomy of the cleft lip-nasal deformity has been fairly well described and a number of surgical procedures have been offered for its correction. Access to the nasal cartilages and precise correction have remained elusive. While a number of internal and external approaches have been proposed, we feel that the gull wing incision gives us excellent exposure for simultaneous visualization of both lower lateral cartilages and places the scar at the base of the columella which seems its best hiding place. With better visualization of the lower lateral cartilages and the employment of Dibbell's cartilage strut technique, we have been able to overcorrect accurately and ultimately achieve better symmetry and more lasting improvement. We have used this approach in the unilateral and bilateral cleft lip-nasal deformity in 15 patients. Principles that have become apparent by virtue of this better exposure include: full dissection of the lateral wings of the lower lateral cartilages and overcorrection using nonabsorbable mattress sutures for cartilage positioning. Pre- and postoperative cases are presented.

Adolescent↗

[Experiences using open rhinoplasty].

In our opinion the procedure recommended by Goodman is very appropriate for modern rhinoplastic surgery. From our own experience of 34 cases we present 3 examples of an asymmetric nasal tip, a hanging columella and a wide saddle nose. The most obvious advantage of the external septorhinoplasty was the excellent exposure, especially of the nasal tip. We used nasal autografts only for the correction of the deformities.

Humans↗

Rhinoplasty.

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Humans↗