The M-Arch Model introduced herein expands on the utility and simplicity of the tripod concept to consider the overall length of the cartilaginous tripod arch as the major determinant of nasal tip parameters. Surgeons may exploit this powerful tool using modern grafting, suture, and cartilage-cutting techniques to predictably achieve desired tip alterations and, by extension, more consistently satisfactory aesthetic outcomes.
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Assessment of dental arch stability after orthodontic treatment and oral rehabilitation in complete unilateral cleft lip and palate and non-clefts patients using 3D stereophotogrammetry.
BMC Oral Health
May 2020
Department of Prosthodontics and Periodontology, Bauru School of Dentistry and Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil.
Background: Although arch stability has been studied in patients without a cleft, evidence for patients with a cleft is sparse. Therefore, we compared the dimensions and stability of dental arches in cleft lip and palate patients and those without a cleft.
Methods: Forty participants, 20 with a complete unilateral cleft lip and palate and 20 non-cleft patients aged from 18 to 30 years, with anterior and/or posterior crossbite and receiving orthodontic treatment were evaluated retrospectively.
Nasal tip deprojection with crural cartilage overlap: the M-arch model.
Facial Plast Surg Clin North Am
February 2015
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto General Hospital, R. Fraser Elliott Building, 190 Elizabeth Street, Room 3S - 438, Toronto, Ontario M5G 2C4, Canada; Adamson Associates Cosmetic Facial Surgery, 150 Bloor Street West, M110, Toronto, Ontario M5S 2X9, Canada. Electronic address:
Vertical arch division is a mainstay of tip surgery, and its applications are expanding. It allows deprojection of the overprojected tip, and modifies rotation, length, and lobule definition. These parameters can be altered in a controlled, predictable fashion when the alar cartilage is preserved and overlapped, maintaining its strength.
View Article and Find Full Text PDFRefining vertical lobule division in open septorhinoplasty.
Arch Facial Plast Surg
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Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
Objective: To review the indications, surgical techniques, and results of vertical lobule division (VLD) of the alar cartilages as they relate to the M-Arch Model.
Design: Retrospective study of patients who underwent VLD of the lower lateral cartilages at a private facial plastic surgery practice in a major university teaching hospital.
Results: Vertical lobule division decreased projection in 34 of 41 patients, narrowed a wide or boxy tip in 25, corrected knuckling or bossae in 20, corrected tip asymmetry in 14, corrected a hanging columella in 14, increased rotation in 12, and decreased rotation in 6.
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Facial Plast Surg Clin North Am
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Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
In rhinoplasty, the nasal tip remains the most challenging anatomic region to diagnose and treat. This article presents a new concept, the M-arch model, to better understand the functional and aesthetic anatomy of the tip. This M-arch can be lengthened or shortened, or left as is, to establish the basis of ideal nasal length, projection, and rotation.
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Curr Opin Otolaryngol Head Neck Surg
August 2007
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Illinois at Chicago, Chicago, Illinois 60611, USA.
Purpose Of Review: Successful rhinoplasty requires a detailed understanding of the nasal structure needed to produce a functional and aesthetically pleasing nose. Recent advances in surgical technique have focused on cartilage repositioning and reshaping, often with the use of cartilage grafting.
Recent Findings: Newer techniques for strengthening the middle vault, stabilizing the base, and modifying the lateral crura are presented, as well as the M-arch model, a modification of the tripod concept.
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