Nose Rhinoplasty Research Articles

Deviated Nose Affects Surgical Success and Quality of Life

Objective: Analyze and compare the surgical outcome and quality of life in patients with and without deviated nose in rhinoplasty. Method: A total of 191 patients who underwent primary rhinoplasty between 2006 to 2009 were enrolled. The study population was separated into nondeviated or deviated groups. The surgical outcome, pre- and postoperative quality of life were assessed using rhinoplasty outcome evaluation (ROE) and EuroQol, and statistically analyzed. Results: A hundred ten cases had deviated nose and 81 cases had nondeviated nose. The vast majority of cases were operated using endonasal approach except 3 cases. When non-deviated and deviated groups were compared according to satisfaction with appearance, breathing problems, friends’ satisfaction with appearance, social interactions, self-confidence, need for additional procedures, ROE score, statistically significant differences were determined. The comparison of pre- and postoperative change in EuroQol (EQ-5 index, living quality index and visual analogue scale) between 2 groups also demonstrated statistically significant differences. Conclusion: The deviated nose is a challenging nasal morphology which may lead to lesser satisfaction in surgical outcome and inadequate improvement in quality of life. Therefore, it should be precisely evaluated in candidates of rhinoplasty.

Treatment Protocol for “Mestizo Nose” with Open Rhinoplasty

The aim of this study was to develop an operative sequence to guide plastic surgeons on how to handle the challenges of "Mestizo nose" during rhinoplasty. This type of nose has characteristics quite different from the Caucasian nose. Rhinoplasties on Mestizo nose represent a surgical challenge because of the anatomical characteristics of a weak frame and thick skin. The Hispanic population has grown, and nowadays a large number of patients requesting rhinoplasty within the US belong to this ethnic group. We have developed an operative sequence for the treatment of Mestizo nose. This operative sequence has been tested in 879 rhinoplasties (92.37% females and 7.62% males, aged 15-63years, mean age=39years). All were primary cases. An algorithm on how to approach the different types of Mestizo nose is presented. We had overall good results using our algorithm, with an improvement in the nasal aesthetics of about 54.75%. Complications were postoperative bleeding (1.37%), pain (0.57%), septal hematoma (0.23%), unaesthetic scars (0.34%), and cartilage extrusion (0.11%). Our revision rate was 5%. We present ten complete cases to show our surgical results. This operative sequence has allowed us to get predictable and reliable surgical outcomes when used in Mestizo rhinoplasty operations. We think it can be very useful for every plastic surgeon who performs Mestizo nose rhinoplasty, although not all steps need to be performed in every case.

Management of the Aging Nose

As a growing segment of our population, mature patients seeking rhinoplasty for both functional and aesthetic reasons will increasingly be encountered by the facial plastic surgeon. The aging process is characterized by a gradual derotation and deprojection of the nasal tip. This article provides an overview of versatile and proven techniques that may be applied to the majority of aging nose rhinoplasty cases and that have been found to yield predictable and lasting results.

“Stuffy Nose” Rhinoplasty: Diced Cartilage Grafts for Correction of Cleft Nasal Tip Deformities

Numerous techniques exist to address poor nasal tip projection in the cleft nose deformity. The authors describe a secondary closed rhinoplasty technique using diced cartilage nasal tip grafting. Cleft patients who previously underwent lower lateral cartilage repositioning with residual poor nasal tip projection underwent the "stuffy nose" rhinoplasty technique in which diced septal cartilage grafts were placed in a pocket made from a unilateral marginal incision over the lower lateral cartilages. Preoperative and follow-up (1 year) comparative measurements included (1) columellar length, (2) alar base-nasal tip-columellar base angle, and (3) lateral tip projection. Twenty cleft patients had improvement in nasal form and tip projection from the stuffy nose rhinoplasty. Mean change from preoperatively to follow-up was as follows: columellar length, 11.3 mm to 13.3 mm (17.7 percent); alar base-nasal tip-columellar base angle, 42.0 to 33.5 degrees (8.5 degrees, or 20.2 percent decrease); and lateral tip projection, 7.7 mm preoperatively to 9.0 mm postoperatively (16.9 percent increase). Two patients developed complications (one graft exposure and one infection) but healed with conservative treatment. Two different patients underwent revisionary nasal surgery but for other concerns (alar base asymmetry and internal nasal valve collapse). The stuffy nose rhinoplasty was shown to objectively improve nasal tip projection in cleft patients with secondary nasal deformities, with minimal complications and decreased need for revisions.

The aging nose in rhinoplasty for facial rejuvenation.

The aging nose in rhinoplasty for facial rejuvenation.

A simple technique to straighten the slightly deviated nose in rhinoplasty

A simple technique to straighten the slightly deviated nose in rhinoplasty

A Simple Technique to Straighten the Slightly Deviated Nose in Rhinoplasty

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The anatomy of the nose. External support.

The anatomy of the nose is poorly defined, even in standard anatomical texts. Wide disagreement exists regarding the interdigitation of the supporting cartilages, the articulation of these cartilages with the nasal bones, and the contribution of each of these cartilages to the support of the external nose. An understanding of this nasal anatomy is essential to the facial plastic surgeon. The authors describe the fundamental anatomical structure of the adult nose based on gross and microscopical observations and serial sections in 31 cadaveric noses. Tables of cartilage measurements and variation, plus appropriate drawings define the anatomy encountered. Structural variations are common and can be predicted by external appearance in selected cases. To discuss relationships of importance in the surgical alteration of the nose in rhinoplasty, anatomical findings are compared to descriptions in the surgical and anatomical literature. Preservation of essential support and physiological function is stressed.