The Pillars Concept: An Approach for Managing Hypertrophic Concha in Otoplasty.

Prominent ear deformities often result from a combination of hypertrophic conchal cartilage and an underdeveloped antihelical fold. Traditional otoplasty techniques, such as antihelical folding sutures and conchal setback maneuvers, may introduce tension and risk of relapse, leading to suboptimal aesthetic outcomes. The PILLARS CONCEPT: represents an alternative surgical approach specifically designed to address hypertrophic concha, ensuring stable and natural results.

The Isosceles Nasal Tip-Laser-Assisted Midline Assessment in Rhinoplasty.

The accurate determination of the nasal tip's spatial location is crucial for achieving symmetry in rhinoplasty. Even minor deviations can result in asymmetrical lengths and configurations of the nostrils. Our approach centers on defining the nasal tip position by establishing the midline of the nasal base and projecting an isosceles triangle.

Precision Rhinoplasty Cylindric Burrs-Sidewall Aesthetics.

The development of power instruments has led to great advances in rhinoplasty. It has helped to reduce operating time, minimize damage to the surrounding soft tissues, and allow precision bony modification compared with the use of manual rasps. Burrs help ensure precise results by (i) creating a smooth transition between the lateral nasal sidewall and the face, (ii) treating bony asymmetries, and (iii) producing homogeneous upper and middle thirds that softy translate into the upper lateral cartilages.

Eyebrow Lift: Open-Book ROOF Transposition and Orbicularis-Frontalis Sliding Maneuver.

This article delves into innovative surgical techniques, the open-book ROOF (retro-orbicularis oculi fat) transposition technique (OBRoof) and the orbicularis-frontalis sliding maneuver (OFS), designed for eyebrow and upper eyelid rejuvenation in the aging process. Emphasis is placed on understanding the dynamic changes occurring within the forehead and eyebrow envelope's five layers and their intrinsic relationships as well as the impact of the ROOF ptosis causing upper eyelid hooding. The OBRoof technique is highlighted for its effectiveness in addressing ptotic volume, offering a rejuvenated appearance by relocating volume to the supraciliary region.

Dorsal Aesthetic Line (DAL) Split Maneuver in Dorsal Preservation Rhinoplasty.

The dorsal aesthetic lines (DALs) osteotomies are a strategy to increase the plasticity of the dorsal pyramid to facilitate control of the convexity of the profile, width of the nasal dorsum, and define the eyebrow-tip aesthetic lines. It is also an alternative to lateral keystone area) disarticulation. This article discusses its advantages, indications, and the technical sequence of the DAL osteotomy procedure.

Cable and Mirror Sutures and the Nasal Septum Sublaminar Dissection.

Managing the nasal septum (NS) position is crucial in septorhinoplasty. The analysis and the preparation of the anterior nasal spine and the quadrangular cartilage as well as the strategy defined to efficiently stabilize the septum will dictate considerably the success of the result. Moreover, what we see in the surgical table can suffer modifications during the healing process because of poor fixation or the cheese-wire effect of the cartilage.

Precision Segmental Preservation Rhinoplasty: Avoiding Widening, Defining New Dorsal Esthetic Lines in Dorsal Preservation Rhinoplasty.

Experiencing great worldwide scientific excitement, the number of nose preservation surgeries has increased rapidly, promoting a considerable percentage of drawbacks and complications, causing many surgeons to recoil and return to classic resective techniques. In this study, we develop concepts that allow us to operate noses with preservation rhinoplasty that were previously considered to be among the absolute contraindications. Redefining new dorsal aesthetic lines, controlling the nasal lateral wall and the naso-facial groove surfaces, avoiding mid-vault widening and being precise in the design of bony and cartilaginous nasal profile, avoiding any type of irregularity, are strategies that will be presented.

Global Practice Patterns of Dorsal Preservation Rhinoplasty.

Dorsal preservation rhinoplasty (DPR) has recently received significant academic attention in part due to theoretical benefits over excisional surgical methods. The purpose of this study was to assess the global practice patterns regarding this technique. An 11-item questionnaire was electronically distributed to regional academies/societies representing rhinoplasty surgeons worldwide.

Conservative Surgery of the Nasal Dorsum: Septal Pyramidal Adjustment and Repositioning.

The term SPAR (septum pyramidal adjustment and repositioning), aims to conserve the nasal dorsum without detachment of the upper lateral nasal cartilage of the nasal septum, based on the Cotte's principles, unlike classical rhinoplasty. The aim of the study is to describe surgical technique of SPAR with the surgical steps used to reviewing the literature on the surgical treatment of the nasal dorsum. This is a less invasive form of rhinoplasty, but no less effective, not being necessary additional techniques to nasal reconstruction, and preservation of essential nasal structures.

Rhinoplasty Dissection Planes (Subcutaneous, Sub-SMAS, Supra-perichondral, and Sub-perichondral) and Soft Tissues Management.

Rhinoplasty as an operation is akin to a game of chess, where every maneuver will influence the eventual outcome. Undoubtedly, more than one approach to the nasal soft tissues envelop can produce beautiful and safe results as will be described in the paper namely, the subcutaneous, sub-superficial musculoaponeurotic system, supra- and sub-perichondral planes. For different justifiable reasons surgeons have their preferences, regarding dissection planes on the tip, middle and upper thirds, and regarding the manipulation of the soft tissue layers and nasal ligaments.

History of Dorsum Conservative Techniques in Rhinoplasty: The Evolution of a Revived Technique.

The correction and management of the nasal hump has been a classic problem in rhinoplasty since the beginning of the aesthetic purpose of this surgery. For many years, the resective technique described by Joseph has been the battle horse to solve this problem but it has several drawbacks if not done properly. In the late 19th and early 20th centuries, a new dorsal conservative technique was born and for several years was an alternative option to treat the same problem without damaging the keystone area while preserving the dorsal connection between the upper lateral cartilage and the septum.