
Rhinoplasty: A Multispecialty Approach, An Issue of Clinics in Plastic Surgery
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Inhalt
- Front Cover
- Rhinoplasty:A Multispecialty Approach
- Copyright
- Contributors
- EDITOR
- EDITORS
- AUTHORS
- Contents
- Preface: Rhinoplasty: Education Through Multispecialty Collaboration
- Surface Aesthetics and Analysis
- Open and Closed Rhinoplasty
- Surgical Treatment of Nasal Obstruction in Rhinoplasty
- Surgical Management of Nasal Airway Obstruction
- Dorsal Hump Reduction and Osteotomies
- Management of the Nasal Dorsum: Construction and Maintenance of a Barrel Vault
- Nasal Bone Osteotomies with Nonpowered Tools
- Surgical Treatment of the Middle Nasal Vault
- Surgical Treatment of the Twisted Nose
- The Crooked Nose
- Reshaping of the Broad and Bulbous Nasal Tip
- Alar Rim Deformities
- Nasal Tip Deficiency
- Projection and Deprojection Techniques in Rhinoplasty
- The Short Nose
- Revision Rhinoplasty
- Pyriform Aperture Augmentation as An Adjunct to Rhinoplasty
- Harvesting Rib Cartilage in Primary and Secondary Rhinoplasty
- Costal Cartilage Grafts in Rhinoplasty
- The Cleft Lip Nose: Primary and Secondary Treat
- Cleft Lip Nose
- Rhinoplasty in Latino Patients
- Rhinoplasty in the African American Patient: Anatomic Considerations and Technical Pearls
- Rhinoplasty in the Asian Patient
- Rhinoplasty in Middle Eastern Patients
- Chin Advancement, Augmentation, and Reduction as Adjuncts to Rhinoplasty
- Use of Fillers in Rhinoplasty
- CLINICS IN PLASTIC SURGERY
- FORTHCOMING ISSUES
- April 2016
- July 2016
- October 2016
- RECENT ISSUES
- October 2015
- July 2015
- April 2015
- Preface: Rhinoplasty: Education Through Multispecialty Collaboration
- Surface Aesthetics and Analysis
- Key points
- NASAL ANALYSIS: LEARN TO SKETCH THE NOSE
- Sketch from the Front
- Sketch from the Side
- Sketch from Above and Below
- AESTHETIC NASAL POLYGONS
- THE NON-MOBILE UPPER NOSE
- THE MOBILE TIP AREA
- Mass Polygons
- Gap Polygons (Cannot Be Seen When the Skin Is Raised)
- DORSAL CARTILAGE POLYGON
- DORSAL BONE POLYGON
- UPPER LATERAL CARTILAGE POLYGONS
- LATERAL BONE POLYGONS
- DORSAL AESTHETIC LINES
- LATERAL AESTHETIC LINES
- THE NOSTRIL CREASE
- THE NASAL TIP
- DOME TRIANGLES AND THE INTERDOMAL TRIANGLE
- TIP-DEFINING POINTS
- WHAT IS THE FACET?
- FACET POLYGONS
- LATERAL CRUS POLYGONS
- RESTING ANGLE
- SCROLL LINE
- INFRALOBULAR POLYGON
- COLUMELLAR POLYGON
- FOOTPLATE POLYGONS
- SUMMARY
- REFERENCES
- Open and Closed Rhinoplasty
- Key points
- INTRODUCTION
- ANATOMY, INCISIONS, AND APPROACHES
- Nasal Anatomy
- Incisions and approaches
- Indications for endonasal versus external
- External and endonasal approaches to the upper third
- External and endonasal approaches to the middle nasal vault
- External and endonasal approaches to the nasal tip
- External and endonasal approaches to revision rhinoplasty
- Endonasal and external approaches to the deviated caudal septum
- Philosophic considerations-a graduated approach: the big picture
- REFERENCES
- Surgical Treatment of Nasal Obstruction in Rhinoplasty
- Key points
- INTRODUCTION
- ANATOMIC CONSIDERATION
- The Nasal Valves
- The External Nasal Valve
- The Internal Nasal Valve
- The Septum
- The Turbinates
- PHYSICAL EXAMINATION
- EXTERNAL NASAL VALVE
- INTERNAL NASAL VALVE
- DEVIATED SEPTUM
- INFERIOR TURBINATE
- OSTEOTOMY
- SUMMARY
- REFERENCES
- Surgical Management of Nasal Airway Obstruction
- Key points
- INTRODUCTION
- ANATOMY
- FUNCTION
- CAUSES
- DIAGNOSIS
- TREATMENT
- SUMMARY
- Dorsal Hump Reduction and Osteotomies
- Key points
- INTRODUCTION
- TREATMENT GOALS AND PLANNED OUTCOMES
- PREOPERATIVE PLANNING AND PREPARATION
- PATIENT POSITIONING
- PROCEDURAL APPROACH
- COMPLICATIONS
- POSTPROCEDURAL CARE
- REHABILITATION AND RECOVERY
- OUTCOMES
- SUMMARY
- REFERENCES
- Management of the Nasal Dorsum
- Key points
- INTRODUCTION
- ANATOMY
- Skin
- Cartilage
- Mucosa
- Inferior Turbinates
- PREOPERATIVE PATIENT EVALUATION
- PREOPERATIVE PATIENT PREPARATION
- Operating Room
- SURGICAL PROCEDURE
- COMPONENT SEPARATION
- BONY VAULT
- REASSEMBLY
- RADIX GRAFT WHEN NEEDED
- POSTOPERATIVE CARE
- COMPLICATIONS
- Functional
- Aesthetic
- REFERENCES
- Nasal Bone Osteotomies with Nonpowered Tools
- Key points
- INTRODUCTION
- CLASSIFICATION OF NASAL BONE DEFORMITIES AND PERTINENT ANATOMY
- VASOCONSTRICTION
- TECHNIQUE
- Osteotomes
- Medial Oblique Osteotomy
- Lateral Osteotomy
- PATIENT EXAMPLES
- DISCUSSION
- SUMMARY
- REFERENCES
- Surgical Treatment of the Middle Nasal Vault
- Key points
- INTRODUCTION
- ANATOMY
- PREOPERATIVE PLANNING AND PREPARATION
- PROCEDURAL APPROACH
- Preparation
- External Approach
- Widening of the Narrow Middle Vault
- Narrowing of the Wide Middle Vault
- Dorsal Hump Reduction for Overprojection
- Dorsal Augmentation for Underprojection
- Correcting the Deviated/Twisted Middle Vault
- POSTPROCEDURAL CARE
- POTENTIAL COMPLICATIONS AND MANAGEMENT
- SUMMARY
- REFERENCES
- Surgical Treatment of the Twisted Nose
- Key points
- INTRODUCTION
- TREATMENT GOALS AND PLANNED OUTCOMES
- PREOPERATIVE PLANNING AND PREPARATION
- PATIENT POSITIONING
- PROCEDURAL APPROACH
- POTENTIAL COMPLICATIONS AND MANAGEMENT OF THEM
- POSTPROCEDURAL CARE
- REHABILITATION AND RECOVERY
- OUTCOMES
- SUMMARY
- SUPPLEMENTARY DATA
- REFERENCES
- The Crooked Nose
- Key points
- INTRODUCTION
- TREATMENT GOALS AND PLANNED OUTCOMES
- PREOPERATIVE PLANNING AND PREPARATION
- PRINCIPLES FOR TREATING THE CROOKED NOSE
- Wide Exposure of Deviated Structures
- Wide Release of Mucoperichondrial Attachments
- Straightening the Deviated Septum and Septal Reconstruction
- Correcting Caudal Septal Deviation
- Correction of Dorsal Septal Deviation
- Restoration of Septal Support
- Inferior Turbinate Surgery
- Nasal Osteotomies
- PROCEDURAL APPROACH
- POSTPROCEDURE CARE
- OUTCOMES
- SUMMARY
- REFERENCES
- Reshaping of the Broad and Bulbous Nasal Tip
- Key points
- INTRODUCTION
- PREOPERATIVE ANALYSIS
- SKIN AND SOFT TISSUE
- TIP SUTURING
- TIP GRAFTS
- Columellar Strut
- Onlay Tip Grafts and Infratip Grafts
- Alar Contour Grafts
- Lower Lateral Crurual Strut and Repositioning
- SUMMARY
- REFERENCES
- Alar Rim Deformities
- Key points
- BACKGROUND
- CLASSIFICATION
- Profile View
- Basilar View
- SURGICAL CORRECTION OF THE DEFORMITIES
- DISCUSSION
- REFERENCES
- Nasal Tip Deficiency
- Key points
- INTRODUCTION
- TREATMENT GOALS AND PLANNED OUTCOMES
- PROCEDURAL APPROACH
- Increasing Tip Projection and Stabilizing the Columellar Base
- Columellar strut graft
- Tip graft
- Caudal septal extension graft
- Strengthening the Lateral Crura
- Case analysis
- Cephalic Malposition of Lateral Crura
- Case analysis
- Elongation of Short Alar Cartilages
- Case analysis
- Congenital Absence or Asymmetries of the Alar Cartilages
- Case analysis
- Secondary Deformities of the Alar Cartilages
- Establishing tip projection and position
- Lateral crural reconstruction
- Case analysis
- POTENTIAL COMPLICATIONS AND MANAGEMENT
- SUPPLEMENTARY DATA
- REFERENCES
- Projection and Deprojection Techniques in Rhinoplasty
- Key points
- INTRODUCTION
- TREATMENT GOALS
- PREOPERATIVE PLANNING AND PREPARATION
- PROCEDURAL APPROACH
- Decreasing Tip Projection
- Preserving Tip Projection
- Increasing Tip Projection
- Suture techniques
- Structural grafts
- SUMMARY
- SUPPLEMENTARY DATA
- REFERENCES
- The Short Nose
- Key points
- INTRODUCTION
- PREOPERATIVE PLANNING AND PREPARATION
- PATIENT POSITIONING
- PROCEDURAL APPROACH
- TECHNIQUE
- Technique 1: Septal Extension Graft
- Case 1: primary rhinoplasty
- Case 2: secondary rhinoplasty
- Technique 2: Rib Graft
- Case 3: secondary rhinoplasty
- Technique 3: Complex Osteotomy Nasal Lengthening
- Case 4: secondary posttraumatic rhinoplasty
- Case 5: posttraumatic rhinoplasty
- POTENTIAL COMPLICATIONS AND MANAGEMENT OF THEM
- Postprocedural Care
- Rehabilitation and Recovery
- SUMMARY
- REFERENCES
- Revision Rhinoplasty
- Key points
- INTRODUCTION
- ASSESSMENT OF PATIENTS WITH REVISION RHINOPLASTY
- COMMON MOTIVATION FOR PATIENTS SEEKING REVISION RHINOPLASTY
- PREPARING FOR REVISION RHINOPLASTY
- COMMON SURGICAL DEFORMITIES AND CORRECTIVE PROCEDURES
- Upper Third of the Nose
- Middle Third
- Lower Third
- Soft Tissue
- SUMMARY
- REFERENCES
- Pyriform Aperture Augmentation as An Adjunct to Rhinoplasty
- Key points
- PREOPERATIVE EVALUATION
- Anthropometric Data
- SURGICAL ANATOMY
- THE IMPLANT
- OPERATIVE TECHNIQUE
- CLINICAL EXAMPLES
- SUMMARY
- REFERENCES
- Harvesting Rib Cartilage in Primary and Secondary Rhinoplasty
- Key points
- INTRODUCTION
- TREATMENT GOALS AND PLANNED OUTCOMES
- PREOPERATIVE PLANNING AND PREPARATION
- PATIENT POSITIONING
- PROCEDURAL APPROACH
- POTENTIAL COMPLICATIONS AND MANAGEMENT OF THEM
- POSTPROCEDURAL CARE
- REHABILITATION AND RECOVERY
- OUTCOMES
- SUMMARY
- REFERENCES
- Costal Cartilage Grafts in Rhinoplasty
- Key points
- INTRODUCTION
- TREATMENT GOALS AND PLANNED OUTCOMES
- Preoperative Planning and Preparation
- Patient Positioning
- Procedural Approach
- POTENTIAL COMPLICATIONS AND MANAGEMENT
- Postprocedural Care
- Rehabilitation and Recovery
- Outcomes
- SUMMARY
- REFERENCES
- The Cleft Lip Nose
- Key points
- CLEFT ANATOMY
- Cleft Lip Repair
- The Incomplete Bilateral Cleft
- Complete Bilateral Clefts
- Technique of Primary Nasal Correction
- Secondary Correction of the Cleft Nasal Deformity
- REFERENCES
- Cleft Lip Nose
- Key points
- INTRODUCTION
- ANATOMY AND EMBRYOLOGY OF THE CLEFT NASAL DEFORMITY
- Unilateral Cleft Lip Nose Deformity
- Bilateral Cleft Lip Nose Deformity
- TREATMENT
- Timing of the Cleft Nasal Repair
- Presurgical Nasoalveolar Molding
- Primary Rhinoplasty
- Intermediate Rhinoplasty
- Orthognathic Surgery
- Secondary (Definitive) Rhinoplasty
- SURGICAL TECHNIQUES
- Approaches
- Septal Reconstruction
- Treatment of the Nasal Tip
- Treatment of the Cleft Alar Rim
- Treatment of the Alar Base
- SUMMARY
- REFERENCES
- Rhinoplasty in Latino Patients
- Key points
- INTRODUCTION
- Concepts of Beauty and Mestizo Patients
- Mestizo Nasal Characteristics
- THE CONSULTATION
- STRUCTURAL APPROACH TO THE MESTIZO OR LATINO NOSE
- SURGICAL TECHNIQUE
- THE UPPER THIRD OF THE NOSE (BONY DORSUM)
- Surgical Solutions
- Slight augmentation
- Moderate augmentation
- Marked augmentation
- THE MIDDLE THIRD OF THE NOSE (CARTILAGINOUS DORSUM)
- Surgical Solutions
- Spreader grafts
- Flaring mattress sutures
- Onlay grafts/crushed cartilage
- LOWER THIRD OF THE NOSE (NASAL TIP)
- The Pedestal
- Surgical Solutions
- Columellar strut
- Caudal septal extension graft
- The Nasal Tip
- Intact tip procedures
- Reduction of the width of the alar cartilage
- Lateral crural turn-in flap
- Suturing techniques
- Lateral crural steal
- Dome-defining sutures
- Alar-spanning suture
- Intercrural suture
- Septocolumellar suture
- Incomplete strip procedures (cartilage splitting techniques)
- Lateral crural overlay
- Medial crural overlay
- Grafts
- Shield graft
- Alar strut grafts
- Alar rim grafts
- Morselized cartilage/crushed cartilage
- THE NASAL BASE
- POSTSURGICAL FOLLOW-UP
- SUMMARY
- SUPPLEMENTARY DATA
- REFERENCES
- Rhinoplasty in the African American Patient
- Key points
- INTRODUCTION
- ANATOMY
- TREATMENT GOALS AND PLANNED OUTCOMES
- PREOPERATIVE PLANNING AND PREPARATION
- SURGICAL TECHNIQUES
- Initial Dissection
- Septoplasty and Inferior Turbinoplasty
- Cartilage Grafting
- Nasal Tip Surgery
- Osteotomies
- Radix and Dorsal Augmentation
- Alar Flare and Base Reduction
- Postoperative Complications and Management
- PRECAUTIONS
- SUMMARY
- REFERENCES
- Rhinoplasty in the Asian Patient
- Key points
- INTRODUCTION
- CHARACTERISTICS OF THE ASIAN NOSE AND CLINICAL IMPLICATIONS
- MANAGEMENT OF THE NASAL DORSUM
- Dorsal Augmentation
- Determining the level and height of the nasion
- Choice of augmentation material
- Dorsal augmentation using alloplastic implant
- Procedural approach
- Avoiding complications using alloplastic implants
- Management of the Dorsal Hump
- MANAGEMENT OF THE NASAL TIP
- Tip Augmentation (Controlling Projection and Rotation)
- The septal extension graft
- Procedural approach
- Managing the Bulbous Asian Tip (Decreasing Volume and Increasing Definition)
- REVISION RHINOPLASTY IN ASIANS
- Alloplast-Related Complication
- Short, Contracted Nose
- Dorsal Deviation and Irregularity
- Tip Problems Related with Septal Extension Graft
- SUMMARY
- SUPPLEMENTARY DATA
- REFERENCES
- Rhinoplasty in Middle Eastern Patients
- Key points
- INTRODUCTION
- TREATMENT GOALS AND PLANNED OUTCOMES
- PREOPERATIVE PLANNING AND PREPARATION
- Procedural Approach to Middle Eastern Rhinoplasty
- Surgical Correction
- Avoiding Potential Complications in Middle Eastern Rhinoplasty
- SUMMARY
- Chin Advancement, Augmentation, and Reduction as Adjuncts to Rhinoplasty
- Key points
- INTRODUCTION
- PREOPERATIVE PLANNING AND PREPARATION
- Chin Deformities
- PROCEDURAL APPROACH
- SURGICAL TECHNIQUE
- Chin Implant
- Fixation of alloplast chin implants
- Osseous Genioplasty
- Osteotomies
- Soft Tissue Fillers
- Postoperative care
- Complications
- SUMMARY
- SUPPLEMENTARY DATA
- REFERENCES
- Use of Fillers in Rhinoplasty
- Key points
- INTRODUCTION
- ANATOMY FOR RHINOPLASTY USING FILLER
- Soft Tissue of the Nose
- Vascular Supply of the External Nose
- SELECTION OF TARGET PATIENT
- METHOD OF PROCEDURE
- COMPLICATIONS
- Bruising
- Asymmetry
- Visible Implant
- Hypersensitivity
- Lumps
- Vascular Compromise
- Intra-arterial Embolism
- Cause
- Symptoms
- Prevention
- Treatment
- Inflammatory Response and Edema
- REFERENCES
- Index
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