Incisor Show-based Selection of Tip Augmentation Rhinoplasty Technique.

Our recent studies show that the majority of patients seeking rhinoplasty have inadequate incisor show. Furthermore, some rhinoplasty maneuvers, such as a columella strut, can alter the lip position and consequently the incisor show. We report the senior author's (B.

The Incidence of Nasal Tip and Upper Lip Malposition in Primary Rhinoplasty.

Background: For an optimal aesthetic plan for correction of nasal tip disharmony, it is crucial to note lip and tip disproportions.

Objectives: In this study we sought to investigate the incidence of preoperative upper lip malposition in primary rhinoplasty patients.

Methods: In total, 150 consecutive primary rhinoplasty patients were included.

Neural Interconnections of Extracranial Nerves in Headache Surgery: Anatomical Landmarks and Clinical Implications: A Review of the Literature.

Headache disorders (HDs) remain a nationwide challenge for the US health care system, affecting nearly 60% of the US population. Surgical deactivation of the peripheral trigger site, also referred to as headache surgery, represents an effective treatment for patients with refractory HD pain or nonresponse to pharmacologic regimens. Research stemming from other surgical specialties has underlined the clinical relevance of neural interconnections in refining diagnostic algorithms, adapting surgical techniques, and improving overall patient outcomes.

An Algorithm for Control of Excessive Perioperative Bleeding and Ecchymosis in Rhinoplasty Patients Based on 4 Decades of Experience.

Background: Persistent intraoperative bleeding, excessive postoperative ecchymosis, epistaxis, and blood collection in the supratip area increase the complexity of rhinoplasty, causing suboptimal outcomes. The authors present an intraoperative bleeding management algorithm, developed by the senior author (B.G.

Evidence-Based Dynamics in Rhinoplasty.

Rhinoplasty is a delicate surgical procedure that requires a thorough understanding of the dynamic interplay between the various structures of the nose. Any changes made to one part of the nose can have downstream effects on the overall harmony and appearance of the nose. For this reason, it is crucial for surgeons to be aware of these potential impacts in order to achieve predictable and aesthetically pleasing results.

Comprehensive Criteria for Differential Diagnosis and a Surgical Management Algorithm for Occipital Neuralgia and Migraine Headaches.

The differential diagnoses and nuances of the surgical management of occipital migraine and occipital neuralgia have not been clearly discussed in the available literature. This study aims to highlight additional diagnostic features and offers an algorithm for the surgical treatment of occipital migraine and occipital neuralgia based on the vast experience of the senior author spanning over 23 years. A retrospective cohort study was conducted to review the number and distribution of patients who underwent surgical treatment for occipital migraine headaches and neuralgia and the signs and symptoms observed.

The Versatile Role of Fat Injection During Various Genioplasties.

Background: Fat injection has become increasingly popular in aesthetic surgery, but there is a sparsity of literature regarding its role during genioplasty. In this study, we present the largest series of patients receiving fat injections to the chin for various indications.

Methods: Data were collected from January 2016 to December 2021 for patients who underwent chin fat injection for a variety of chin refinements.

Chin Dysmorphology in the Primary Rhinoplasty Population: Prevalence, Objective Analysis, and Implications.

Background: Chin flaws are far more common than recognized. Denial of genioplasty by parents or adult patients can present a surgical planning enigma, especially in patients with microgenia and chin deviation. This study aims to investigate the frequency of chin imperfections on patients seeking rhinoplasty, review the conundrum they generate, and offer management suggestions based on over 40 years of the senior author's experience.

The Logical Sequence of Primary Open Rhinoplasty Founded on the Principles of Rhinoplasty Dynamics.

Rhinoplasty is a perplexing procedure due to the variety of complex interplays between anatomical structures of the nose and the maneuvers used to accomplish the intended objective. Although every rhinoplasty is individualized, having a systematic order and an algorithm is crucial to achieve the designed aesthetic goals and a superior outcome, considering the interactions between maneuvers. Otherwise, the accumulated, unanticipated effects will result in displeasing outcomes due to over or under correction.

Common Dorsal Flaws Following Preservation Rhinoplasty: A Systemic Analysis.

Background: There has recently been a resurgence of interest in preservation rhinoplasty (PR) for dorsal hump elimination or dorsal projection reduction. However, no studies have scrutinized aesthetic outcomes to identify common pattern of flaws seen in published images to aid those with ardent enthusiasm for this technique to become aware of the frequency of these flaws and find ways to reduce imperfections.

Methods: A systematic literature review was performed using search terms ("preservation" OR "let down", "push down") AND "rhinoplasty" on PubMed, Cochrane, SCOPUS, and EMBASE databases for studies between January 2000 and December 2022.

Exploring the Resurgence of the Preservation Rhinoplasty: A Systematic Literature Review.

Introduction: The underlying principles of preservation rhinoplasty (PR) center around maintaining the soft tissue envelope, dorsum, and alar cartilage through surgical manipulations and tip suture techniques. In particular, the let-down (LD) and push-down (PD) techniques have been described, although reports of indications and outcomes in the literature are sparse.

Methods: A systematic review of the literature was performed using search terms "preservation" OR "let down" OR "push down" AND "rhinoplasty" on PubMed, Cochrane, SCOPUS, and EMBASE databases.

Nonpharmacologic Treatments for Chronic and Episodic Migraine: A Systematic Review and Meta-Analysis.

Background: Minimally invasive techniques for treatment-resistant migraine have been developed on recent insights into the peripheral pathogenesis of migraines. Although there is a growing body of evidence supporting these techniques, no study has yet compared the effects of these treatments on headache frequency, severity, duration, and cost.

Methods: PubMed, Embase, and Cochrane Library databases were searched to identify randomized placebo-controlled trials that compared radiofrequency ablation, botulinum toxin type A (BT-A), nerve block, neurostimulation, or migraine surgery to placebo for preventive treatment.

Frequency, Indications and Intraoperative Dynamics of Repositioning of the Lateral Crura of the Lower Lateral Cartilage: A 35-Year Experience.

Background: Lower lateral cartilage repositioning (LLCR) is an effective technique that places the lateral crus in a newly created caudal pocket, and is utilized for a variety of indications including cephalic malposition, alar asymmetries and tip rotation/projection alteration. However, there is a relative sparsity in the literature regarding this procedure and the dynamic changes that it produces. In this study, we report our experience with LLCR in regard to its indications and related interplays.

Evolution and Versatility of the Bilateral Extended Spreader Graft: A Review and an Update to the Tongue-and-Groove Technique.

Background: Initially introduced by the senior author (B.G.) for lengthening the short nose, bilateral extended spreader grafts (BESG) in the form of the tongue-and-groove (TAG) technique have gained additional indications in current septorhinoplasty practice.

The External Rhinoplasty Approach.

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.

The Evolution of Migraine Surgery: Two Decades of Continual Research. My Current Thoughts.

A mere serendipitous finding has culminated in a life-changing development for patients and a colossally fulfilling field for many surgeons. The surgical treatment of migraine headaches has been embraced by many plastic surgeons after numerous investigations ensuring that the risks are minimal and the rewards inestimable. Seldom has a plastic surgery procedure been the subject of such scrutiny.

Surgical Options for Migraine: An Overview.

Objective: The goal of this manuscript was to provide a comprehensive review of the surgical treatment for migraine headaches with a focus on trigger points and their clinical presentations, and to emphasize the importance of appropriate patient selection.

Background: Migraine is a prevalent neurological disease with headache being a disabling component of it. Surgical treatment for migraine headache became available two decades ago, which is based on proper identification and the deactivation of the specific trigger sites in the head and neck area.

Delayed Septal Perforation as a Complication of COVID-19: A Case Report.

Background: There are increasing reports of the effects of SARS-CoV-2 on olfactory function, with a significant number of patients reporting anosmia as a symptom. However, our knowledge and understanding of the virus's complete impact on the nose remains poor. This report describes a unique patient case to demonstrate how COVID-19 may be associated with rhinoplasty complications such as septal perforation.

Economizing the Septal Cartilage for Grafts During Rhinoplasty, 40 Years' Experience.

Background: During rhinoplasty, it is typically necessary to use cartilage to shape and support the final nasal construct to provide both form and function to the nose (Tanna et al. in Plast Reconstr Surg 141(1):137e-151e, 2018; Guyuron in Plast Reconstr Surg 105(6):2257-2259, 2000; Kim et al. in Ann Plast Surg 65(6):519-523, 2010).

The Prevalence of Blepharoptosis in Facial Rejuvenation Patient Population.

Background: Facial rejuvenation results, commonly seen in publications or national presentations, are fraught with uncorrected eyelid ptosis. This study was conducted to investigate the frequency of blepharoptosis in the rejuvenation population and to help increase awareness in recognizing this under corrected condition.

Methods: Fifty-nine consecutive patients being evaluated for facial rejuvenation were included in the study.