Controlling the Nasal Dorsum

2020 ◽  
pp. 257-269
Author(s):  
Natarajan Balaji
Keyword(s):  
2021 ◽  
Vol 37 (01) ◽  
pp. 045-052
Author(s):  
Mario Bazanelli Junqueira Ferraz ◽  
Guilherme Constante Preis Sella

AbstractNasal dorsal preservation surgery was described more than 100 years ago, but recently has gained prominence. Our objective is to show the surgical technique, the main indications and counterindications, and the complications. It is a technique that does not cause the detachment of the upper lateral cartilage (ULC) from the nasal septum, and has the main following sequence: preparation of the septum and its resection can be at different levels (high or low, i.e., SPAR [septum pyramidal adjustment and repositioning] A or B); preparation of the pyramid; transversal osteotomy; lateral osteotomy(s); and septopyramidal adjustment. The result is a nose with a lower radix than the original, a deprojection of the nasal dorsum tending to maintain its original shape; an increase in the interalar distance (IAD) and enlargement of the nasal middle ⅓; and loss of projection of the nasal tip and roundness of the nostrils. Thus, the ideal candidate is the one who benefits from such side effects, that is: tension nose, that is, high radix with projected dorsum, projected anterior nasal septal angle (ANSA), narrow middle ⅓, narrow IAD, thin nostrils and straight perpendicular plate of the ethmoid (PPE), and, depending on the characteristics, the deviated nose. The counterindications are low radix, irregularities in the nasal dorsum, ANSA lower than rhinion, and a wide middle ⅓. And the main stigmas are: a nose with a very low radix, middle ⅓ enlarged, residual hump, and saddling of the supratip area. Other issues of this technique are: the shape of the radix; the need or not to remove PPE; wide dorsum; irregular dorsum; ANSA lower than rhinion; weak cartilages; long nasal bone; deviated PPE; and obsessive patient. We conclude that this is a great technique for noses with characteristics suitable to it; care must be taken with the stigmas it can cause.


Author(s):  
Emrah Kağan Yaşar ◽  
Can İlker Demir ◽  
Buket Dursun ◽  
Murat Şahin Alagöz

Author(s):  
Hyoung-Jin Moon ◽  
Won Lee ◽  
Do Hyun Kim ◽  
Il Hwan Lee ◽  
Soo Whan Kim
Keyword(s):  

2000 ◽  
Vol 105 (7) ◽  
pp. 2433 ◽  
Author(s):  
Norman Weinzweig ◽  
Gloria Chin ◽  
John Polley ◽  
Fady Charbel ◽  
Harish Shownkeen ◽  
...  

Author(s):  
Vitaly Zholtikov ◽  
Vladimir Golovatinskii ◽  
Riadh Ouerghi ◽  
Rollin K Daniel

Abstract Background Camouflage of nasal dorsum, aesthetic augmentation and highlighting the dorsal aesthetic lines are essential elements in modern rhinoplasty. Numerous techniques have been utilized including deep temporal fascia, rectus abdominis fascia, and diced cartilage in fascia (DC-F). Despite their wide spread adoption, technical challenges remained, especially when utilized for aesthetic purposes. Objectives The paper details the use of fascia (F) and diced cartilage in fascia grafts (DC-F) for aesthetic dorsal refinement in primary and secondary cases. One of the main goals was to achieve ideal dorsal aesthetic dorsal lines rather than just volume augmentation. Methods We used grafts from the deep temporalis fascia (F) and rectus abdominis fascia (RF) in 4 configurations: 1) single layer, 2) double layer, 3) full length diced cartilage in fascia grafts (DC-F), and 4) partially filled – segmental DC-F grafts. Technical refinements included careful determination of dimensions and meticulously suturing to the dorsum at appropriately 10 points to prevent graft displacement. Results We report our experience: 146 clinical cases over 35 months from January 2017 to December 2019. The patients were divided for 4 groups depending on which type of graft was used. Conclusions Use of autogenous deep temporal fascia, rectus abdominis fascia, and diced cartilage in fascia (DC-F) to camouflage dorsal irregularities, to highlight dorsal aesthetic lines, and to aesthetically augment either the entire nasal dorsum or its individual parts. Optimization of cutting, stitching, filling the graft, careful fixation of these grafts on the nasal dorsum, significantly increases the predictability of these techniques and minimizes problems.


2020 ◽  
pp. 159-181
Author(s):  
Patrizia Schiavon ◽  
Rosa Maria Minniti ◽  
Maria Chiara Cimatti ◽  
Matteo Campa

2020 ◽  
Vol 65 (2) ◽  
pp. 145
Author(s):  
Jianmei Yin ◽  
Lei Zhu ◽  
Haibo Liu ◽  
Zhongying Fu
Keyword(s):  

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