Nasal Tip Rhinoplasty Research Articles

Septal extensor 2024 with costal cartilage: total fusion of architecture and engineering in primary rhinoplasty. An advanced surgical technique of the nasal tip

Adjusting the lower third of the nose can be considered the most complicated part of nose surgery. The caudal septal edge is usually located behind the nasal spine without direct contact; Additionally, thick skin contributes to limited definition of the nose, especially at the nasal tip. Repairing these problems and their consequences represents a genuine challenge for the cosmetic surgery surgeon, especially considering the importance of correcting imperfections in the bone and cartilaginous structure of the nose, including alterations in the nasal cartilages themselves, such as the partial or complete lack of the same, which may be the result of a process of absorption or necrosis of the tissues. The purpose of this document is to explain the implants used in the nasal tip during a primary rhinoplasty as part of aesthetic surgery of the nose, with the purpose of supporting an innovative technique called Septal Extender 2024. A novel surgical technique is presented and also carried out a retrospective descriptive analysis by reviewing medical records, surgical procedures for primary nasal tip rhinoplasty with septal extender.

Cartilage Remodeling in Nasal Tip Rhinoplasty Using "Lateral Crural Steal" and "Tongue in Groove" Strategies: A Randomized Controlled Trial.

The authors present their experience using "Lateral Crural Steal" (LCS) and "Tongue in Groove" (TING) techniques in nasal tip remodeling. The paper aimed to evaluate the efficacy and safety of the use of LCS and TING in nasal tip remodeling for aesthetic improvement. A randomized controlled trial was conducted. Thirty-five patients affected by low and boxy nasal tips were treated with LCS and TINGs (study group [SG]), comparing results with the control group (CG) (n = 30) treated with cartilage grafts. The preoperative analysis has been performed with an accurate clinical evaluation, a photographic assessment, and a computed tomography scan. Postoperative follow-up took place at 1, 2, and 4 weeks, 3, 6, and 12 months, and then annually. A total of 82.9% (n = 29) of SG patients showed excellent cosmetic and functional results after 1 year compared with the CG patients, who showed the same results in only 40% (n = 12) of cases. The tip projection maintenance and contour restoring in the SG were higher than that in the CG ( P < 0.0001 versus CG). The use of LCS and TING was safe and effective in this series of cases performed.

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

BackgroundRhinoplasty 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.ResultsThis 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.ConclusionIt 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.

New Concepts in Nasal Tip Rhinoplasty.

Cosmetic rhinoplasty involves surgical manipulation of the nasal cartilages, nasal bones, lining mucosa and extracartilaginous soft. The nasal tip is a complex composite arrangement of tissues. These structures are responsible for creating individuality and asymmetries and for controlling nasal air entry and valving. Medical aesthetics involves filling relevant areas of the tip with hyaluronic acid to disguise grooves or soft defect contour defects. Standard tip surgery involves an open or closed approach. Manipulation of the flexible alar cartilage using intracartilaginous and interartilaginous sutures is preferable to resection, and alar base reduction is becoming more prevalent.

Clinical efficacy of double M-shaped cartilage used in nasal tip cosmetic plasty

Objective To explore the clinical effect of double M-shaped cartilage used in nasal tip cosmetic plasty. Methods From December 2016 to May 2017, nasal fip plasty was performed in 39 patients in Hangzhou Huashan Luyeme Medical Cosmetology Hospital. With the Goodman's incision in the columella and nasal vestibule, a big piece of autologous nasal septal cartilage was removed and transplanted to the front of nasal septum. Ear cartilage was trimmed into two strips and sutured with nasal septum cartilage graft. Meanwhile, the sandwich cartilage graft was inserted between the lower lateral cartilages to form the first M shape stent when fixing part of it on the nasal septum. Then the ear cartilage was turned over and fixed with lateral crus of the lower lateral cartilages to form the second M shape stent. Willow-shaped prosthesis was placed into the nasal dorsum. Results A total of 39 cases of nasal tip surgery were performed, including 1 male and 38 females. Ages ranged from 21 to 48 years in this group. The follow-up period was from 1 month to 5 months. 36 patients were satisfied with the efficacy while 2 patients were suffered from the deviation of nasal tip, one patient was suffered from nasal septum deviation. Conclusions The application of double M-shaped cartilage in nasal tip cosmetic plasty is one of ideal rhinoplasty approaches with less wound, simple procedure and good clinical effects. Key words: Ear cartilage; Septal cartilage; Double M-shaped cartilage stent; Nasal tip rhinoplasty

Application of ear cartilage in reconstruction of domal graft in nasal tip rhinoplasty

Objective To investigate the application of auricular cartilage in nasal plastic surgery and its clinical effects of the different tip graft and reconstructed domal graft (RDG). Methods From October 2009 to May 2015, the surgical procedure was performed on 286 patients, through the application of cymba and conchae cartilages into various tip graft and RDG in nasal tip plasty. Results A total of 286 patients were followed up post-operatively for 3 months to 5 years, 245 patients (85.7% achieved expected stability tip, the tip down to 1-2 mm after one year. Tip skin thinning was observed in 10 patients after one year, nasal tip down occurred in 89 patients; the columella skew and asymmetric nostrils occurred in 31 patients. Conclusions The ear cartilage can be made into various tip graft for rhinoplasty, with satisfactory clinical outcomes. Key words: Auricular cartilage; Rhinoplasty; Graft

Porcine Cartilage Model for Simulation of Nasal Tip Aesthetics and Mechanics

The aesthetics of the human nose is highly dependent on the complex structure of the lower lateral cartilages (LLC). Understanding optimum shape and mechanical properties of the LLC is pivotal to achieving satisfactory results in nasal tip rhinoplasty. The authors introduce an ex vivo animal model to replicate the shape and mechanics of human nasal LLC as a tool for research and surgical education. Seven fresh pig heads were obtained from a local butcher shop. Nasal cartilage was harvested in a replicable manner and fashioned into appropriate shapes and dimensions based on the authors' human cadaver studies. Sutures were placed to approximate the cartilage pairs into appropriate human anatomical position. The porcine cartilage model replicated analogous structures, including the medial crura and the lateral crura, with appropriate cephalic orientation and domal angles. The anterior-posterior dimensions of the medial crura, intermediate crura, and lateral crura were 4 mm, 6 mm, and 10 mm, respectively. Cartilage thickness was approximately 1 mm throughout the specimen. Cephalic orientation of the lateral crura was sculpted to 45°. The average angle of divergence was 54° and varied according to the physiological shape of the porcine nasal vault (range, 43-74°). Average interdomal distance was 13.3 mm (range, 9-18 mm), and average domal width was 6.2 mm (range, 5-7 mm). This novel porcine model mimics human LLC and is inexpensive, easy to construct, and highly replicable. This model can be used as a valuable educational resource for training novice surgeons in the principles of nasal tip rhinoplasty. Additionally, our construct has broad applications in studying LLC geometry and mechanics.

Application of sub-unit principle in nasal tip rhinoplasty

目的 介绍以亚单位原则指导鼻尖成形术的方法和经验.方法将鼻尖分成鼻翼、软组织三角、尖部和鼻小柱等亚单位,根据各亚单位的形态结构特点,结合鼻尖的美学参数,判断受术者鼻尖外观的缺陷,据以设计3种手术方法:切除法、缝合法和移植法.结果随访216例,手术满意率89%(192例),基本满意率9%(20例),不满意率2%(4例).结论亚单位原则指导鼻尖成形术,能获得准确、稳定和满意的手术效果。

An approach to nasal tip remodeling

The luxation (cartilage delivery) technique may be used to achieve a predictable, individualized result in nasal tip rhinoplasty. The author describes how this technique, using a bipedicle flap with an intercartilaginous and rim incision, allows superior visualization of the domal region without structural disruption of the cartilaginous arch. (Aesthetic Surg J 2001;21:345-348.)

Developments in Nasal Tip Rhinoplasty

Developments in Nasal Tip Rhinoplasty

Nasal Tip Rhinoplasty: The Cartilage-Splitting with Delivery Technique

Nasal Tip Rhinoplasty: The Cartilage-Splitting with Delivery Technique