The fascial system of the face (superficial musculo-aponeurotic system, SMAS) in the nasal part is a sustained layer that connects the nearby regions. In this paper, we aimed to emphasize the presence of SMAS in different areas of the nasal region: ala nasi, nasolabial fold, nasal dorsum and radix. We performed three studies (anatomical, histological, and radiological) to demonstrate the existence of nasal SMAS. The study group consisted of cadaveric analyses and retrospective analysis of the patient radiological data. The nasal SMAS was identified as a superficial fascia and a subcutaneous adipose layer. The anatomical dissection study together with histological and radiological evaluations demonstrated the presence of SMAS in the nasal region. We identified peculiarities of the nasal SMAS in two areas: in the ala nasi where it is thinner, and the deep part of the dermis does not adhere to the underlying structures and at the radix and dorsum nasi, where the adipose layer is very thin. The results of our research define nasal SMAS as a unit of great value in facial surgeries, such as facial rejuvenation, the resolution of malformations, or tumor removal.
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http://dx.doi.org/10.47162/RJME.64.2.10 | DOI Listing |
Aesthet Surg J Open Forum
October 2024
Background: Management of dorsal dead space and the aesthetics of a supratip break are paramount to achieving reproducible and reliable results in rhinoplasty.
Objectives: The authors present a modified technique of redraping the nasal soft tissue envelope in structural rhinoplasty by utilizing the nasal superficial musculoaponeurotic system (SMAS) to help obliterate dorsal dead space and restore normal anatomy, thereby enhancing midvault and supratip contouring.
Methods: A standard open rhinoplasty approach is utilized.
Facial Plast Surg
September 2024
Department of Otolaryngology, Head and Neck Surgery, Barts Health NHS Trust, London, United Kingdom.
The nasal radix holds significant importance in facial aesthetics, sometimes requiring augmentation to create balanced facial profiles. A flat nasal radix can cause inadequate projection and the appearance of a pseudo-hump. In these cases, rhinoplasty surgeons should avoid working on the pseudo-hump and focus on elevating the radix to achieve the desired aesthetic outcome.
View Article and Find Full Text PDFFacial Plast Surg
September 2024
Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota.
Nasal reconstruction presents the facial plastic surgeon with a complex problem given its functional and aesthetic importance. The dorsal nasal flap is a composite rotational flap of the glabella and nasal dorsum that can be used for nasal dorsum and tip defects of medium to large sizes. Given its composite nature, this flap can be split into its constituent parts-the epidermis and dermis and the subcutaneous tissue and superficial musculoaponeurotic system-without flap loss.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
January 2024
Beaches Facial Plastic & Nasal Surgery Center, Jacksonville Beach, Fla.
Background: Cervicofacial rhytidectomies are one of the most common procedures in the United States. There are many different methods and techniques involved, but all aim to minimize blood loss and procedure time. In our study, we investigated the addition of tranexamic acid (TXA) to tumescent anesthesia during rhytidectomy procedures.
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