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1.
Clin Plast Surg ; 49(1): 1-11, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782128

RESUMO

Requiring both high-level technical skills and artistic sense, rhinoplasty continues to be one of the most challenging procedures in plastic surgery despite its popularity. A thorough preoperative consultation of the rhinoplasty patient forms the foundation of a successful case. During the consultation, the physician should obtain a detailed medical and nasal history, understand the patient's areas of concern, conduct a nasal analysis, and evaluate the patient's candidacy for surgery. This article reviews the key functional, esthetic, and psychosocial considerations that should be taken into account during a preoperative consultation for a rhinoplasty patient.


Assuntos
Rinoplastia , Cirurgia Plástica , Estética , Humanos , Nariz/cirurgia , Cuidados Pré-Operatórios
2.
Clin Plast Surg ; 49(1): 111-121, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782129

RESUMO

The crooked nose is a challenging esthetic and functional problem. The surgeon must carefully evaluate baseline facial asymmetry as well as whether deviation stems from the upper third, middle third, or lower third of the nose. Surgical intervention should be tailored accordingly, with techniques geared toward addressing each deviated section. Modified dorsal preservation techniques represent a newer means to address deviations. Operative results must be measured, ideally through patient-reported outcomes measures, to quantify overall success.


Assuntos
Deformidades Adquiridas Nasais , Rinoplastia , Estética , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Resultado do Tratamento
3.
Clin Plast Surg ; 49(1): 123-136, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782130

RESUMO

An understanding of anatomy and pathophysiology of the cleft nasal deformity is crucial to its management, including selection of correct surgical techniques for repair. Timing of intermediate and definitive rhinoplasty should be considered carefully, with definitive rhinoplasty occurring after management of facial skeletal deformities. At the time of definitive rhinoplasty, the septum, external and internal nasal valves, alar base malposition (and corresponding bony deficiency), and position and shape of the lower lateral cartilage and the columella all must be individually considered. Thorough knowledge of rhinoplasty techniques is crucial to address the cleft nasal deformity with optimal functional and aesthetic outcomes.


Assuntos
Fenda Labial , Rinoplastia , Cartilagem , Fenda Labial/cirurgia , Estética , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia
4.
Clin Plast Surg ; 49(1): 137-148, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782132

RESUMO

To manage the deficient nasal dorsum, a thorough knowledge of dorsal augmentation techniques should be mastered by the rhinoplasty specialist. Indications for dorsal augmentation may arise in both primary and revision rhinoplasty presentations. To direct operative planning, a complete facial analysis, noting the importance of maintaining overall nasofacial balance, is essential. An array of techniques, including autologous and nonautologous (ie, allogeneic and synthetic) sources, have been used globally-each carrying its own advantages and disadvantages. The authors believe autologous grafts to be the optimal source for dorsal augmentation because of their biocompatibility and ability to produce natural and long-lasting outcomes.


Assuntos
Fáscia , Rinoplastia , Fáscia/transplante , Humanos , Nariz/cirurgia , Coleta de Tecidos e Órgãos , Transplante Autólogo
5.
Clin Plast Surg ; 49(1): 149-160, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782133

RESUMO

Today non-Caucasian patients comprise an important group of patients seeking rhinoplasty. The term non-Caucasian is used interchangeably to speak about patients of ethnic origin. It becomes important to understand the interplay of culture, race, and ethnicity when evaluating patients and defining what their aesthetic ideals are and what will be needed for surgery. An integrated approach and management of the non-Caucasian patient is presented in which medical and surgical options are explored. The final goal when treating non-Caucasian patients should be trying to help patients achieve their aesthetic ideal in the best possible fashion.


Assuntos
Rinoplastia , Estética , Grupos Étnicos , Humanos , Nariz/cirurgia
6.
Clin Plast Surg ; 49(1): 161-178, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782134

RESUMO

Treatment of nasal base deformities is critical for a successful rhinoplasty. Several anatomic variations are seen on nasal base. Alar base deformities can be horizontal excess or deficiency, vertical excess or deficiency, cephalic malposition or caudal malposition of alar base, wide or narrow nostril sills, and columellar base deformities. Columellar base should be addressed before alar base resections. Correction of columellar base deformities and positioning of medial crural footplates should be the primary step of nasal base surgery to attain aesthetic ideals of the columellar base and improve external nasal valve function. The most common deformities requiring alar base modification include wide nasal base, alar flaring, large nostril size, and asymmetries of nostrils or alae. There are 3 basic types of excision on alar base surgery. (1) Alar wedge excision, (2) nostril sill excision, and (3) combined alar wedge and nostril sill excision. The alar wedge excision is an elliptical excision placed in the alar crease that is used to reduce the size and shorten the vertical length of alar lobule and correct the excessive flaring on the frontal view. Nostril sill excision is the technique which is used to decrease interalar distance and nostril sill length, and reduce the size of nostril. The combined alar wedge and nostril sill excision is used in cases with wide alar base and additionally, there is excessive flaring and large alar lobule.


Assuntos
Procedimentos Ortopédicos , Rinoplastia , Estética , Humanos , Cavidade Nasal , Septo Nasal/cirurgia , Nariz/cirurgia
7.
Clin Plast Surg ; 49(1): 191-195, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782136

RESUMO

Nonsurgical rhinoplasty is increasing in popularity, and when used appropriately, can be less costly and have less downtime than surgical rhinoplasty. It can offer patients a means of seeing how they would feel about a surgical rhinoplasty later. Injection can be safe but patients should still be counseled regarding the rare, possible risks of tissue loss and potentially irreversible tissue ischemia and irreversible blindness. Treatment with hyaluronidase can be partially effective when signs and symptoms are caught early; however, avoidance is still the best medicine along with seeking an experienced, qualified rhinoplasty plastic surgeon.


Assuntos
Rinoplastia , Humanos , Isquemia , Nariz/cirurgia
8.
Clin Plast Surg ; 49(1): 49-59, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782139

RESUMO

The nose is a complex three-dimensional structure with critical structural and functional roles; its relationship to surrounding structures is, in part, responsible for a harmonious, pleasing visage as a whole. There are many variables and dimensions that can be adjusted to alter the esthetic appearance, structural components, and functional role of the nose and many tools and maneuvers available to the rhinoplasty surgeon to adjust these numerous variables. Although every rhinoplasty operation should be individualized, a systematic order and algorithm may be helpful in operative planning as well as establishing a logical progression of steps and maintaining stability. While each adjustment may have a primary anticipated effect, it will invariably have a secondary impact.


Assuntos
Rinoplastia , Algoritmos , Humanos , Nariz/cirurgia
9.
Clin Plast Surg ; 49(1): 61-70, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782140

RESUMO

Controlling the nasal tip to achieve excellent structural and cosmetic outcomes is challenging in rhinoplasty surgery. A strong foundation and understanding of the nasal tripod complex and the various methods for restoring tip support mechanisms when disrupted either from surgery or other means is critical. The columellar strut graft, septal extension graft, and tongue-in-groove suture technique are well-described methods to control and support the nasal tip. There are advantages and disadvantages to each method, but one should be comfortable with the nuances of each to master nasal tip surgery.


Assuntos
Nariz , Rinoplastia , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia , Próteses e Implantes , Técnicas de Sutura
10.
Clin Plast Surg ; 49(1): 81-95, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782142

RESUMO

Dorsal hump reduction is one of the most common techniques used in modern rhinoplasty, yet it carries a high propensity for untoward aesthetic and functional sequelae, as evidenced by a nontrivial revision rate. Component dorsal hump reduction with stepwise deconstruction and manipulation of component parts allows for an adaptable and precise approach to variances in anatomy and in desired aesthetic result. Secondary changes must be anticipated and addressed at the index operation to avoid negative results and prevent the need for revision. Adequate reconstruction of the midvault is paramount to achieving optimal aesthetic and functional outcomes.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Rinoplastia , Estética , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia
11.
J Craniofac Surg ; 32(8): 2671-2676, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727469

RESUMO

ABSTRACT: Long-term follow-up results of many surgical techniques for lip adhesion are unavailable. Thus, we report the surgical results of patients who underwent lip adhesions performed by a single surgeon. We retrospectively analyzed two-dimensional photographs of 29 patients aged 1 year who underwent lip adhesion and definite lip repair. Among these patients, we analyzed the photographs of 20 patients aged 6 years who underwent secondary rhinoplasty. The ratio of the cleft side length to the noncleft side length was calculated. Only the upper lip length in the photographs of 1-year-olds was measured; both the upper lip and nose lengths were measured in the photographs of 6-year-olds. Lip width, vermilion height, and medial lip height on the cleft and non-cleft sides of 1-year-olds were not significantly different; the alar base width ratio was 1.17 ±â€Š0.15, and the lateral lip height ratio was 0.91 ±â€Š0.09 (P < 0.001). No significant differences were observed in lip width and vermilion height between the cleft and non-cleft sides of the upper lip of 6-year-olds; the alar base width ratio was 1.22 ±â€Š0.16, medial lip height ratio was 1.11 ±â€Š0.11, and lateral lip height ratio was 0.89 ±â€Š0.09 (P < 0.05). There were no significant differences in the alar projection and nasal dome height on the cleft side of the nose; the nostril height and width ratios were 0.82 ±â€Š0.11 and 1.31 ±â€Š0.21 (P < 0.001), respectively. These consecutively performed lip adhesions for patients with wide unilateral complete cleft lip resulted in excellent long-term results. Therefore, lip adhesion for wide unilateral complete cleft lip is a reasonable alternative to presurgical molding.


Assuntos
Fenda Labial , Fissura Palatina , Rinoplastia , Criança , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Lábio/cirurgia , Nariz/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
12.
J Craniofac Surg ; 32(8): 2845-2847, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727485

RESUMO

ABSTRACT: Accessory nostril or supernumerary nostril is one of the rare congenital deformities of the nose. The first case was reported by Lindsay B (1906),1 since then 42 cases have been reported in the literature. There is no uniform surgical approach to treat this anomaly. The authors present a child with left side accessory nostril with bilateral choanal atresia and describe our surgical approach.


Assuntos
Atresia das Cóanas , Criança , Atresia das Cóanas/diagnóstico por imagem , Atresia das Cóanas/cirurgia , Humanos , Nariz/cirurgia
13.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 56(11): 1174-1178, 2021 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-34749456

RESUMO

Objective: To evaluate the application of island flap and combined flap in one-stage reconstruction of nasal alae defects after external nasal tumor resection. Methods: Data of 11 patients with perforating or full-thickness defects of the alae after nasal tumor resection in XuanWu Hospital, Capital Medical University between June 2016 and February 2021 were analyzed retrospectively. There were 7 males and 4 females, and the ages ranged from 51 to 89 years. Island flap, island flap combined with nasolabial flap or V-Y advancement flap, and island flap combined with bilobed flap were applied according to the range of defects. Descriptive statistical method was applied to analyze the treatment effects. Results: All flaps of the 11 patients were successful survival and the incisions were primary healing. Being followed up for 5 to 59 months, the patients had satisfying appearance and ventilation function, and no tumor relapsed. Conclusion: For the patients with nasal alae defects after external nose tumor resection, selecting suitable island skin flap or combined skin flap can be used to reconstruct the ideal nasal appearance and function of the nose.


Assuntos
Neoplasias Nasais , Procedimentos Cirúrgicos Reconstrutivos , Rinoplastia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Estudos Retrospectivos , Transplante de Pele , Retalhos Cirúrgicos
14.
J Craniofac Surg ; 32(8): 2821-2822, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727484

RESUMO

ABSTRACT: Rhinophyma, the final stage of acne rosacea, severely influences the patient's appearance and can only be treated by surgical methods. This case reports a simple, safe, effective, and economical surgical method-five-blade scratcher. After the surgical treatment, the overall nasal contour of the patient, a male with severe rosacea, was restored without scar formation. Thus, this surgical method reported in this case is feasible and easy to operate, and worthy of clinical promotion.


Assuntos
Rinofima , Rosácea , Cicatriz , Humanos , Masculino , Nariz/cirurgia , Rinofima/cirurgia , Instrumentos Cirúrgicos
15.
HNO ; 69(12): 1019-1032, 2021 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-34762159

RESUMO

With increasing age, structures of the internal and external nose change. Many elderly patients complain about rhinitis with nasal obstruction, endonasal crusting, epistaxis, intermittent rhinorrhea, and olfactory disorders. These symptoms are mainly caused by atrophy of the mucosa and the olfactory epithelium, but may also be an expression of drug side effects. Additionally, there are changes in the shape of the nose (continuous growth, altered elasticity of supporting structures) and in the dermis, which may develop tumors due to its sun-exposed position. These multiple internal and external changes of the nose can be summarized by the collective term "aging nose," whose treatment options are complex. These range from conservative (nasal care, medication changes, hemostatic measures) to surgical lines of therapy (septorhinoplasty, tumor excision, vascular ligation) and will require further scientific study in the future.


Assuntos
Obstrução Nasal , Transtornos do Olfato , Rinite , Rinoplastia , Idoso , Humanos , Obstrução Nasal/cirurgia , Nariz/cirurgia
16.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(5): 560-565, 2021 Oct 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34636204

RESUMO

OBJECTIVES: This study aimed to compare the postoperative outcome of the new and classical muscular reconstruction technique combined with nasal internal-fixation method for secondary deformity post unilateral cleft lip repair. A rationale is provided for the further surgical improvement of secondary deformities. METHODS: Sixty patients aged 4-18 years with secondary unilateral cleft lip-nose deformity were involved in this research. The deformities of 28 patients were repaired using the muscular force balance technique through nasal internal fixation method, and 32 were repaired using classical muscular reconstruction technique. Two-dimensional analysis was used to evaluate the nose-lip morphology of pre- and post-operative patients through standardized photographs seven days after surgery. RESULTS: Compared with preoperative nasal morphology in the muscular force balance technique group, the 7-days postoperative results of this group showed the significantly improved short-term outcomes in the correction of columellar deflection, alar rim angle, nasal shape, and the symmetry of alar base width, nostril width, nostril height, alar rim angle (P<0.05). CONCLUSIONS: The new muscular reconstruction technique with nasal internal-fixation method has a significant effect on nasal repair.


Assuntos
Fenda Labial , Rinoplastia , Fenda Labial/cirurgia , Humanos , Nariz/cirurgia , Período Pós-Operatório , Resultado do Tratamento
17.
J Clin Pediatr Dent ; 45(4): 284-290, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34534300

RESUMO

OBJECTIVE: To evaluate nostril morphology post-cheiloplasty after patients with unilateral cleft lip and palate (UCLP) use of the nasal creator device. STUDY DESIGN: This is a prospective study. Sixteen patients with nonsyndromic UCLP treated at Khon Kaen University underwent cheiloplasty and then wear the nasal creator device for 6 months. Three-dimensional images were taken, from which 5 lines and 8 landmark points were evaluated prior to (T0) and 1 day (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after cheiloplasty. A Repeated Measure ANOVA was used to evaluate nostril changes between time periods and a paired t-test was used to compare values between the affected and non-affected side at T4 (P < .05). RESULTS: On the affected side, the nostril height significantly increased from T0 (2.46±0.89 mm) to T4 (4.22±1.03 mm), and the nostril width significantly decreased from T0 (9.46±2.57 mm) to T4 (7.34±1.41 mm). On the non-affected side, the nostril height significantly increased from T0 (3.39±0.78 mm) to T4 (4.65±1.07 mm), and the nostril width was not significantly different from T0 (6.00±1.25 mm) to T4 (6.59±0.95 mm). The alar base width was not significantly different between T0 (30.18±2.72 mm) and T4 (29.82±1.69 mm). Nostril height and width were not significantly different by T4 when comparing the affected and non-affected sides. CONCLUSION: Using nasal creator device for 6 months significantly increased the nostril height and decreased nostril width and alar base width after cheiloplasty.


Assuntos
Fenda Labial , Fissura Palatina , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Humanos , Nariz/cirurgia , Fotogrametria , Estudos Prospectivos , Tailândia , Resultado do Tratamento
18.
Hautarzt ; 72(10): 913-921, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34529088

RESUMO

The nose has an important function in the esthetic perception of the face. The esthetic coverage of defects on the nose is therefore of particular importance; however, the position is exposed to sunlight and poses a particular risk for the development of non-melanoma skin cancer (NMSC) and melanomas. After tumor excision, the size of the defect is decisive for defect closure. In addition, multilayer defects in which the cartilage or mucous membranes must be reconstructed by plastic surgery, represent a particular challenge for the surgeon. There are various options for reconstruction depending on the extent of the defects on the nose. This article gives an overview of the paramedian forehead flap, the indications and implementation.


Assuntos
Neoplasias Nasais , Rinoplastia , Testa/cirurgia , Humanos , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Retalhos Cirúrgicos
19.
Facial Plast Surg Clin North Am ; 29(4): 575-588, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34579839

RESUMO

The main objectives of rhinoplasty in African descendants are to improve the definition and projection of the nasal tip, augment the dorsum, and reduce the alar base. Open rhinoplasty using costal cartilage graft, with lateral crural tensioning and septal extension graft associated with en bloc dorsal augmentation is the workhorse. Cartilage resections should be minimal. Oral isotretinoin and triamcinolone injection may improve tip definition. Surgical success ultimately depends on the ability of the surgeon to accurately identify the anatomic variables and reconcile these anatomic realities with the patient's aesthetic expectations and his or her sense of ethnic identity.


Assuntos
Cartilagem Costal , Rinoplastia , Estética , Feminino , Humanos , Masculino , Nariz/cirurgia , Costelas
20.
Facial Plast Surg Clin North Am ; 29(4): 589-609, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34579840

RESUMO

Symmetric pocket formation and meticulous implant carving are the most critical parts of nasal dorsal augmentation using implants. Innovative three-dimensional printed nasal implants can exactly fit the nasal dorsal contour, decreasing the chance of deviation and malpositioning. Vertically oriented folded dermal graft technique can avoid the high resorption rate of conventional dermofat grafts. Multilayered costal cartilage graft technique for dorsal augmentation can minimize warping and difficulty in the graft carving. Derotation graft allows supple and movable nasal tip while enabling enough tip lengthening, even if the septal extension graft is the most commonly performed procedure for short nose correction.


Assuntos
Cartilagem Costal , Rinoplastia , Grupo com Ancestrais do Continente Asiático , Humanos , Nariz/cirurgia , Reoperação
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