Rhinoplasty is a Common Procedure in Plastic Surgery

Rethinking Rhinoplasty and Facial Surgery, 2020

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Srpski Arhiv Za Celokupno Lekarstvo, 2022

Introduction/Objective Aesthetically, the nose adds special signature to a person's look. This results in many nasal pyramid surgeries, either functional or aesthetic. The problem arises in aesthetic surgeries. Patients often tend to present their dissatisfaction with the appearance of the nose as a breathing difficulty, as they often lack the support of the environment in the decision to undergo cosmetic surgery. The objective of the paper was to examine, using subjective assessment and objective measurements, the change in the nasal respiratory function in patients who undergo aesthetic nose surgeries, despite having a straight nasal septum before the surgery. Methods The study was conducted as a prospective, cross-sectional one, and involved 32 patients of both genders. Before and at six months after surgery all patients underwent subjective nasal breathing assessment using visual analog scale (grade 0-10) as well as objective nasal respiratory function assessment using rhinomanometry and acoustic rhinometry after anemization. Results There were seven male and 25 female patients, age ranging 18-27 years. Objective measurements after surgery showed that the nasal cavity volume, minimum cross-sectional area, as well as the airflow through the nose reduced, while resistance to the nasal airflow increased, but with no statistical significance. The subjective assessment of nasal breathing statistically significantly improved after the surgery. Conclusion The subjective assessment of nasal breathing postoperatively is not a relevant indicator of the objective state of the nasal respiratory function in patients after aesthetic rhinoplasty.

Aesthetic Surgery Journal, 2013

Surface aesthetics of the attractive nose are created by certain lines, shadows, and highlights, with specific proportions and breakpoints. Our evaluation of the nasal surface aesthetics is achieved using the concept of geometric polygons as aesthetic subunits, both to define the existing deformity and the aesthetic goals. Surgical techniques have been developed and modified to achieve the desired surface appearance, and those are detailed in this article. The principles of geometric polygons allow the surgeon to analyze the deformities of the nose, to define an operative plan to achieve specific goals, and to select the appropriate operative technique. These aesthetic concepts and surgical techniques were used in 257 consecutive rhinoplasties performed in the past 3 years by the principal author (B.Ç.).

Aesthetic Surgery Journal, 2010

When evaluating patients for rhinoplasty, it is important to assess for nasal airway obstruction. Indeed, a significant subset of rhinoplasty patients seek to improve both the aesthetics of their nose and their nasal breathing. Typically, the functional and cosmetic portions of the procedure are addressed together. Therefore, it is critical that the rhinoplasty surgeon be armed with a knowledge of both the external and intranasal anatomy, the differential diagnosis of nasal obstruction, the elements of a complete nasal examination (including nasal endoscopy), and the medical and surgical treatment options. Although medical treatment

2014

The approach used by the founding fathers of rhinoplasty has incorrectly been called “closed” rhinoplasty, since the term “closed” suggests that the surgeon cannot see or access vital areas of the nose during surgery. The term “endonasal” more accurately describes this particular approach. However, with the advent of “open” or “external” septorhinoplasty in the late ‘70s, the former “endonasal” techniques were progressively abandoned. “Open” rhinoplasty is the most commonly taught approach to residents in Otolaryngology, Plastic Surgery and Maxillo-Facial Surgery in western countries thanks to its advantages in terms of surgical exposure and consequent teaching/learning easiness. Furthermore, most medical literature now a days focuses on “open” procedure, thus making “closed” rhinoplasty appear an out-of-date approach not worthy to be learnt and developed. We describe the principles of “endonasal” rhinoplasty with respect to “open” approach, together with the present and potential f...

British Journal of Oral and Maxillofacial Surgery, 2015

Resection of cancer often involves the excision of underlying hard tissue, and some procedures in aesthetic rhinoplasty can be used in reconstructive nasal surgery to increase the margin of safety while still achieving an acceptable aesthetic and functional outcome. We have used techniques from aesthetic rhinoplasty to shape the nasal framework. Osteotomy and formation of the tip were used in 17 patients with defects (ranging from 1 to 3.5 cm in size) from the nasal root to the tip of the nose. After the underlying bony or cartilaginous framework, or both, had been removed, the resulting open roof deformity had to be corrected by osteotomy of the bony nasal wall and the tip shaped by excision and suturing, including insertion of the tip graft and columellar strut graft. After this, and narrowing of the nose, the defect was smaller and could be closed with local tissue without tension. There were no deformities in the contour, and patency of the airway was maintained. Patients were satisfied with both the aesthetic and functional results. Although the margin of safety was increased, shaping the nasal framework reduced the size of the defect, which allowed tension-free closure with a local flap. The operation requires a thorough knowledge of procedures used in aesthetic rhinoplasty.

Aesthetic Surgery Journal, 2016

Rhinoplasty is perhaps the most complex cosmetic surgery procedure performed today. It is characterized by an intricate interplay between form and function, with patient satisfaction being dependent not only on improvement of nasal appearance but also resolution of preexisting airway symptoms. The prerequisite for successful execution of this challenging procedure is a thorough understanding of nasal anatomy and physiology. Hence, a thorough preoperative evaluation is at least as important and the surgical skill in performing the operation. Establishing an accurate diagnosis through a comprehensive nasal analysis is obligatory. As to the surgical approach, much has been written about the advantages and disadvantages of closed vs open rhinoplasty. The more commonly chosen open approach has numerous advantages, including improved visualization without distortion, thus, enabling precise diagnosis and correction of deformities. While the surgical treatment of existing nasal deformities is tailored to the needs of the individual patient, the authors have noted a total of 10 essential components to form the foundation for successful technical execution of rhinoplasty. These include: (1) septoturbinotomy; (2) opening the nose; (3) humpectomy/spreader flaps; (4) tip-plasty; (5) supratip-plasty; (6) columellar strut; (7) dorsal augmentation; (8) nasal base reduction; (9) osteotomies; and (10) rim grafts. Postoperative, a variety of problems, such as edema, may be successfully addressed without surgical intervention. Diligent postoperative management is critical in ensuring a positive patient experience. Finally, a comprehensive understanding of possible postoperative complications, such as bleeding, ecchymosis, edema, and persistent or new iatrogenic deformity is mandatory prior to offering rhinoplasty to patients.

Aesthetic Plastic Surgery, 2011

Rhinoplasty modifies the aesthetic appearance and functional properties of the nose with operative manipulation of the skin, underlying cartilage, bone, and linings. A long nose is an aesthetically undesired feature disturbing the harmony of the face. The underlying pathology of the long nose may be due to either a long septum that invades the lip or dislocation of the alar cartilages downward from the aponeurotic attachments to the septal angle. The increase in the nasal height due to a dorsal nasal hump may give an illusion of a long nose. An absent or shallow frontonasal angle also gives the illusion of a long nose. With the introduction of the dynamics of the nasal structures and dynamics in rhinoplasty, recreation of a straight nasal dorsum and a normal frontonasal angle dynamically shortens the long nose. This study presents a multicenter experience (three centers) in rhinoplasty of long noses. The study included 138 patients who complained of having a long nose. The study employed the concept of structure rhinoplasty to address the threedimensional nasal structures contributing directly or indirectly to the appearance of the long nose rather than the traditional excisional techniques. Based on objective and subjective evaluation, shortening of the nose was achieved in 122 patients (88.4%) with better overall nasal aesthetics. The study concluded that structure rhinoplasty, which addresses the three-dimensional nasal anatomy, maximizes the aesthetic and functional outcomes when treating the long-nose deformity.

Otolaryngology–Head and Neck Surgery, 2017

Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work. The resultant psychological impact of rhinoplasty can also be significant. Furthermore, the health care burden from psychological pressures of nasal deformities/aesthetic shortcomings, surgical infections, surgical pain, side effects from antibiotics, and nasal packing materials must also be considered for these patients. Prior to this guid...

2021