Narrowing the Wide Tip via Endonasal Approach

2021 ◽  
Author(s):  
Omotara Sulyman ◽  
Steven Dayan
Keyword(s):  
Healing Time ◽  
Open Rhinoplasty ◽  
Endonasal Approach ◽  
Nasal Tip ◽  
Nasal Anatomy ◽  
Facial Plastic ◽  
The Aesthetic ◽  
Contractile Forces ◽  
Tip Rhinoplasty ◽  
Gain Access

AbstractRhinoplasty is arguably the most complex and intricate surgery performed by facial plastic surgeons. Nasal tip refinement of a broad nasal tip has remained the most challenging part of rhinoplasty as sophisticated techniques are critical to achieve aesthetically pleasing and structurally sound nasal tips that can withstand the contractile forces of healing. Successful tip refinement relies on an in-depth preoperative and intraoperative understanding of the patient's nasal anatomy, well developed arsenal of techniques, the experience of the surgeon, and the aesthetic desires of the patient. Although the approach to gain access to the nasal tip so as to successfully reshape the tip has been a topic of debate over many years, the aim of this article is to outline and demonstrate how the broad nasal tip can be successfully recontoured through an endonasal approach using nondestructive techniques that have been effectively used in open rhinoplasty. We believe that there continues to be a place for endonasal tip rhinoplasty especially in this era in which patients desire less invasive procedures with shorter healing time.

Open Rhinoplasty

2020 ◽  
Author(s):  
Ginger Xu ◽  
Paul Hwang ◽  
Nargiz Seyidova ◽  
Samuel J. Lin
Keyword(s):  
Key Words ◽  
Preoperative Evaluation ◽  
Surgical Techniques ◽  
Postoperative Management ◽  
Black Box ◽  
Open Rhinoplasty ◽  
Nasal Tip ◽  
Nasal Anatomy ◽  
Nasal Function ◽  
Type Of Surgery

Rhinoplasty is often considered the black box of plastic surgery. This apprehension can be overcome by having a fine-tuned understanding of nasal anatomy, developing an appreciation for nasal aesthetics, and becoming well-versed in the array of surgical techniques available to address specific cosmetic and functional concerns. Technical care and finesse are required in this type of surgery, where even 1 mm of change can result in a profound difference. Nasal function must also be assessed and preserved during rhinoplasty. Aside from these technical points, it is equally important to accurately and thoroughly understand each patient’s goals and to communicate the realistic outcomes and limitations of what can be done through surgery.   Key words: open rhinoplasty, nasal anatomy, nasofacial analysis, rhinoplasty techniques, rhinoplasty preoperative evaluation, rhinoplasty postoperative management, lateral nasal osteotomies, nasal tip grafts, nasal tip suture techniques This review contains 23 figures, 2 tables, and 43 references.

scholarly journals Evaluation of the effectiveness of the use of free diced cartilage in dorsal and tip nasal rhinoplasty

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Amr Gouda Shafik ◽  
Mohamed Naguib Mohamed ◽  
Hassan Mohamed Hassan
Keyword(s):  
Nasal Obstruction ◽  
Outcome Evaluation ◽  
Open Rhinoplasty ◽  
Nasal Tip ◽  
Advantages And Disadvantages ◽  
Evaluation Scores ◽  
Symptom Evaluation ◽  
Significant Difference ◽  
Diced Cartilage ◽  
Tip Rhinoplasty

Abstract Background Rhinoplasty is considered one of the most challenging operations in the plastic surgery. Esthetic or functional reshaping purposes of the nose can be stressing for both surgeon and patient. Different types of graft materials have been used to perform augmentation rhinoplasty. Free diced cartilage (FDC) was recently established in dorsal nasal rhinoplasty for better handling of irregularities as well as contour deficits of dorsal nasal outcomes. The main purpose of the present study is to assess the effectiveness of the use of FDC in dorsal nasal and nasal tip rhinoplasty and evaluation of its advantages and disadvantages using the validated Nasal Obstruction Symptom Evaluation (NOSE) scale and the Rhinoplasty Outcome Evaluation (ROE) questionnaire to assess nasal obstruction and patient satisfaction. Results This prospective study was conducted between March 2018 and December 2019, 20 patients were included and planned for rhinoplasty using FDC to camouflage dorsal and nasal tip deformities. All patients (11males and 9 females) underwent open rhinoplasty through inverted v columellar incision, taken FDC from nasal septum. A statistical significant difference between pre- and post-operative NOSE scores was found (P < 0.001). Post-operative rhinoplasty outcome evaluation scores ranged from 45 to 100 with mean ± SD (83.15 ± 13.22). Excellent satisfaction was the most noted in 17 patients (85%), while 2 patients (10%) reported good satisfaction and 1 patient (5%) with acceptable satisfaction. Conclusion It was found that the FDC technique is an effective method for camouflage and augmentation of nasal dorsum as well as nasal tip in reconstructive and esthetic rhinosurgery for either primary or secondary rhinoplasty.

Nasal Obstruction after Mohs Surgery: Prevention and Correction

2020 ◽  
Vol 36 (01) ◽  
pp. 084-090
Author(s):  
Shannon F. Rudy ◽  
Jeffrey S. Moyer
Keyword(s):  
Risk Factors ◽  
Nasal Obstruction ◽  
Nasal Reconstruction ◽  
Mohs Micrographic Surgery ◽  
Micrographic Surgery ◽  
Plastic And Reconstructive Surgery ◽  
Nasal Anatomy ◽  
Facial Plastic ◽  
The Aesthetic ◽  
Nasal Function

AbstractAs rates of Mohs micrographic surgery (MMS) have risen over recent decades in the setting of increased incidence of nonmelanoma skin cancer, so too has the need for post-Mohs reconstruction. The nose is one of the most common sites of post-MMS nasal reconstruction and presents unique challenges that often require expertise in facial plastic and reconstructive surgery. In addition to the aesthetic importance of the nose, preserving nasal function and preventing nasal obstruction are paramount to successful nasal reconstruction. This article will provide a brief review of nasal anatomy, with a focus on particular anatomic risk factors for post-MMS reconstruction nasal obstruction, strategies to prevent nasal obstruction, as well as techniques to correct the problem when it arises.

Management of an epidermoid cyst in the nasal tip of a child: aesthetic and surgical considerations

2013 ◽  
Vol 127 (10) ◽  
pp. 1028-1030 ◽  
Author(s):  
F R Datema ◽  
G M Bran ◽  
V C M Koot ◽  
P J F M Lohuis
Keyword(s):  
Case Report ◽  
Dermoid Cyst ◽  
Surgical Management ◽  
Treatment Option ◽  
Epidermoid Cyst ◽  
Open Rhinoplasty ◽  
Nasal Tip ◽  
Skin Tension ◽  
The Aesthetic ◽  
Subcutaneous Lesion

AbstractBackground:A simple subcutaneous lesion such as an epidermoid cyst can present a challenge when located in the nasal tip, as regards aesthetic surgical management. Even when performed parallel to relaxed skin tension lines, a direct transcutaneous incision (commonly used for epidermoid cyst removal) distorts the nasal tip subunit, resulting in a conspicuous, disfiguring scar. This should be avoided, especially in children.Case report:A 13-year-old girl was referred by her dermatologist for diagnosis and treatment of a slowly progressive dermoid cyst located on the tip of her nose. The cyst was removed using a subcutaneous open rhinoplasty approach, leaving the aesthetic nasal tip subunit intact.Conclusion:For aesthetic reasons, open rhinoplasty should be considered as a treatment option in patients with subcutaneous lesions in the nasal tip.

Management of the nasal tip by open rhinoplasty

1996 ◽  
Vol 24 (3) ◽  
pp. 145-150 ◽  
Author(s):  
G. Raspall ◽  
J. González-Lagunas
Keyword(s):  
Open Rhinoplasty ◽  
Nasal Tip

In-office Endonasal Minor Revision Rhinoplasty

2021 ◽  
Author(s):  
Samuel R. Auger ◽  
Anil R. Shah
Keyword(s):  
General Anesthesia ◽  
Operating Room ◽  
Recovery Time ◽  
Plastic Surgeon ◽  
Endonasal Approach ◽  
Revision Rhinoplasty ◽  
Minor Revision ◽  
Facial Plastic ◽  
Level Of Experience ◽  
Technical Considerations

AbstractThe revision rhinoplasty presents many unique challenges to the facial plastic surgeon. While many cases will require a full revision in the operating room, there are several isolated deformities which may be repaired in the office via an endonasal approach. This provides many benefits to the patient and surgeon including decreased cost, shorter recovery time, avoidance of general anesthesia, and less discomfort. It is critical to identify defects appropriate for endonasal repair, establish clear expectations with the patient, and work within one's skill set and level of experience. The surgeon who can comfortably navigate both open and endonasal techniques can offer their patients a comprehensive set of solutions for revision rhinoplasty. In this article we outline the defects amenable to this type of repair as well as technical considerations for each defect addressed. We hope it serves as a useful framework for the range of deformities the rhinoplasty surgeon may take on for in-office repair.

Open rhinoplasty using a columellar strut: effects of the graft on nasal tip projection and rotation

2020 ◽  
Vol 277 (5) ◽  
pp. 1371-1377 ◽  
Author(s):  
S. Bucher ◽  
S. Kunz ◽  
M. Deggeller ◽  
D. Holzmann ◽  
M. B. Soyka
Keyword(s):  
Open Rhinoplasty ◽  
Nasal Tip ◽  
Tip Projection ◽  
Columellar Strut ◽  
Nasal Tip Projection

Neurotoxins

2019 ◽  
Vol 35 (03) ◽  
pp. 230-238
Author(s):  
Adrian A. Ong ◽  
David A. Sherris
Keyword(s):  
Botulinum Toxin ◽  
Clinical Applications ◽  
Facial Nerve Paralysis ◽  
Hypertrophic Scars ◽  
Nerve Paralysis ◽  
Facial Plastic Surgery ◽  
Off Label ◽  
Brow Ptosis ◽  
Facial Plastic ◽  
The Aesthetic

AbstractBotulinum toxin is integral to the practice of facial plastic surgery. Since it was approved by the U.S. Food and Drug Administration for the temporary improvement of glabellar rhytids in 2002, botulinum toxin has achieved a growing number of off-label clinical applications. These include the management of facial rhytids, brow ptosis, excessive gingival display, masseteric hypertrophy, platysmal banding, facial nerve paralysis, hypertrophic scars, and keloids. Many forms of botulinum toxin have been developed, and their safety and efficacy have been thoroughly established. This article will review the aesthetic and functional uses of botulinum toxin as it relates to the field of facial plastic and reconstructive surgery. In addition, the authors will discuss the suggested quantity of units per injection site based on onabotulinumtoxinA.

Use of 2-Octylcyanoacrylate (Dermabond) Tissue Adhesive for Tip Graft Fixation in Open Rhinoplasty

2011 ◽  
Vol 145 (5) ◽  
pp. 737-741 ◽  
Author(s):  
Jin-Young Min ◽  
Yong Ju Jang
Keyword(s):  
Complication Rate ◽  
Soft Tissues ◽  
Costal Cartilage ◽  
Tertiary Care ◽  
Case Series ◽  
Tissue Adhesive ◽  
Open Rhinoplasty ◽  
External Approach ◽  
Cartilage Grafts ◽  
Nasal Tip

Objectives. To describe the use of 2-octylcyanoacrylate (2-OCA; Dermabond) for fixation of cartilage grafts in nasal tip surgery via an external approach in Asian patients. Study Design. Case series with chart review. Setting. Academic tertiary care medical center. Subjects and Methods. This retrospective study analyzed data from 33 Korean patients who underwent open rhinoplasty using 2-OCA tissue adhesive for fixation of cartilage grafts in tip surgery. Autologous septal, conchal, costal, or homologous costal cartilage was used as graft materials. Layers of cartilages were bonded using 2-OCA tissue adhesive, and care was taken to prevent the tissue adhesive from spilling and directly contacting surrounding soft tissues. Preoperative and postoperative photographs were reviewed for objective and subjective assessment of aesthetic outcomes. Results. Postoperative aesthetic outcomes were graded as excellent in 51.5%, fair in 33.3%, and no change/worse in 15.2% of patients. Preoperative and postoperative anthropometric measurements showed that the nasal tip projection increased (0.53 ± 0.03 vs 0.57 ± 0.05; P < .05) and the nasolabial angle improved (92.54 ± 6.95 vs 96.12 ± 5.20; P < .05). The overall complication rate was 24.2%, and complications included erythema (9.1%), infection (12.1%), and aesthetic dissatisfaction (3.0%). Conclusion. Although using 2-OCA tissue adhesive for tip surgery simplifies the surgical procedures of fixating graft materials, the relatively high complication rate may preclude its use in nasal tip surgery via an external approach for Asian noses.

Sign in / Sign up

Export Citation Format

Share Document