Nasal Deviation and Facial Asymmetry in Patients Undergoing Rhinoplasty.

Background: The existing literature is conflicted on whether nasal deviation is primarily attributable to trauma or the result of asymmetric facial development.

Objectives: The aim of this study was to establish the prevalence of nasal trauma and facial asymmetry in patients undergoing rhinoplasty, and to determine if a correlation exists between the laterality of facial asymmetry and nasal deviation.

Methods: A retrospective review was undertaken of patients who had undergone primary rhinoplasty with the senior author over a 12-month period.

CUPID Lip Lift: Advanced Lip Design Using the Deep Plane Upper Lip Lift and Simplified Corner Lift.

Background: Upper lip lift is achieved with a variety of techniques but many questions remain about the benefits and drawbacks of each technique. The CUPID deep plane or modified upper lip lift procedure has recently been introduced to help mitigate risk and optimize outcomes.

Objectives: The aims of this study were: (1) to better characterize and simplify the complex and artistic decision-making process involved in upper lip lift and corner lip lift; (2) to present a mathematical guide to maintain the natural balance of the upper lip, optimizing muscle function, and to indicate when to add a corner lift; and (3) to elucidate design elements, aging, and future treatment considerations.

Change in Columellar-Philtral and Nasolabial Angles Over Time Following Rhinoplasty.

Preoperative analyses of the columellar-philtral and nasolabial angles (CPA and NLA) are important considerations for the rhinoplasty surgeon. This study aims to quantify and compare the degree of change in nasal tip rotation as measured by CPA and NLA over time following rhinoplasty and to identify surgical maneuvers or patient characteristics that may affect nasal tip rotation. Prospective analysis of CPA and NLA in 111 consecutive, consenting cosmetic, and/or functional rhinoplasty patients of the senior author over a 1-year time period was performed.

Use of Computer Imaging in Rhinoplasty: A Survey of the Practices of Facial Plastic Surgeons.

Objective: The objective of this study was to quantify the use of computer imaging by facial plastic surgeons.

Methods: AAFPRS Facial plastic surgeons were surveyed about their use of computer imaging during rhinoplasty consultations. The survey collected information about surgeon demographics, practice settings, practice patterns, and rates of computer imaging (CI) for primary and revision rhinoplasty.

Dorsal Augmentation in Rhinoplasty: A Survey and Review.

Understanding the nuanced practices and grafting options of dorsal augmentation will improve outcomes and results in rhinoplasty. To better understand the practices of dorsal augmentation among our colleagues. To review the current literature regarding the indications, safety profiles, and outcomes of different materials used in dorsal augmentation.

Rhinoplasty: panel discussion.

Should one use an open or closed rhinoplasty approach? How appropriate is the endonasal approach in modern-day rhinoplasty? Should the tip lobule be divided or preserved? Are alloplastic implants inferior to autologous implants? Does release and reduction of the upper lateral cartilages from the nasal dorsal septum always require spreader graft placement to prevent mid one-third nasal pinching in reduction rhinoplasty? Over past 5 years, how have rhinoplasty techniques and approaches evolved?

Axial computed tomography evaluation of the internal nasal valve correlates with clinical valve narrowing and patient complaint.

Background: The objective of this work was to explore the utility of axial computed tomography (CT) imaging to objectively define a narrow internal nasal valve, and compare those findings with clinical examination and patient complaint.

Methods: Retrospective review from a single facial plastic surgery center. We reviewed 40 consecutive patients evaluated for either sinusitis or nasal airway obstruction for which a CT scan was obtained at a single radiology institution.

An anatomic basis for revision rhinoplasty.

As the popularity of rhinoplasty has increased, so have the expectations of both patients and surgeons alike. Revision rhinoplasty has become an evolving field with unique challenges. One must first address the patient's specific concerns and emotional issues.

Radix grafts in cosmetic rhinoplasty: lessons from an 8-year review.

We describe our experience with radix augmentation during cosmetic rhinoplasty over an 8-year period using both autologous and synthetic grafts and provide insight into maximizing success. We discuss various surgical considerations, including patient selection, graft materials, and dealing with complications. We focus on our operative technique and provide patient examples.

Avoiding complications of the middle vault in rhinoplasty.

Functional and aesthetic abnormalities of the middle nasal vault are frequent reasons for seeking revision rhinoplasty. Complications in rhinoplasties are inevitable; understanding their etiology can help reduce their occurrence. We will examine the more common sequelae, likely causes, and predisposing factors as well as strategies for prevention.

Functional and aesthetic concerns of patients seeking revision rhinoplasty.

Objectives: To assess the subjective aesthetic and functional concerns of patients seeking revision rhinoplasty and to compare them with objective deformities found on evaluation by the surgeon.

Methods: This prospective study used a questionnaire to systematically target the aesthetic and functional concerns of 104 consecutive patients seeking revision rhinoplasty. Analysis of the subjective data revealed the frequency of each concern, which was then compared with objective deformities found on evaluation by the surgeon.

Incidence of alarplasty in primary and revision rhinoplasty in a private practice setting.

Objective: To evaluate the incidence of alarplasty in primary and revision rhinoplasty during a 3-year period.

Methods: We conducted a retrospective medical record review of patients undergoing primary and revision rhinoplasty between January 1, 2004, and December 31, 2006. Patients were divided into the following categories: primary or revision rhinoplasty, alarplasty, and ethnicity.

Surgical treatment of the nasolabial angle in balanced rhinoplasty.

Aesthetic rhinoplasty is a complex surgical procedure that contains numerous components; when performed harmoniously, it should yield a successful, balanced result. The process begins with a comprehensive nasal analysis and surgical planning. Many surgeons concentrate on altering the nasal dorsum and nasal tip but may ignore potential contributions to overall appearance from the caudal nasal septum and nasal spine.

Nasal valve reconstruction: experience in 53 consecutive patients.

Objectives: To determine the cause of nasal valve obstruction in a series of patients requiring surgical correction, to evaluate the efficacy of our surgical techniques, and to assess the cosmetic effect of nasal valve repair.

Methods: Retrospective review of 53 consecutive cases involving adult patients who underwent nasal valve reconstruction over an 8-year period. The preoperative symptom severity, cause of nasal valve obstruction, preoperative photographs, anatomical findings at the time of surgery, and reconstructive techniques were reviewed.

Surgical treatment of the nasolabial angle in balanced rhinoplasty.

Nasal analysis and surgical planning are crucial for a successful, aesthetically pleasing rhinoplasty. One of the key parameters for evaluation is the nasolabial angle. The nasal spine, caudal septum, and medial crura of the lower lateral cartilages provide the framework for this area.