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Rhinoplasty grafts

Domenico Scopelliti, Giulia Amodeo
The secondary nasal surgery represents a challenging surgical procedure. The difficulties in fact are several: the surgeon must make an effort to achieve the functional and aesthetic consequences of the previous surgical procedure, has to correct the aesthetic and functional imperfections, and has to work on a fibrotic and altered framework.The goal of the secondary nasal surgery is then to restore the normal nasal proportions correcting any functional inability unresolved by the previous surgery or determined by it...
September 29, 2016: Journal of Craniofacial Surgery
E Arnaud, G Paternoster, S James, M-P Morisseau-Durand, V Couloigner, P Diner, C Tomat, V Viot-Blanc, B Fauroux, V Cormier-Daire, G Baujat, M Robert, A Picard, S Antunez, R Khonsari, L Pamphile-Tabuteau, C Legros, M Zerah, P Meyer
The complexity of treatment of faciocraniosynostosis justifies the treatment in a reference center for rare diseases. The growth disturbances in the skull and face being variable according to the type of mutation in the FGFr (Crouzon, Pfeiffer, Apert), the strategy is adapted to the phenotype according to the following principles: posterior expansion with or without distraction around 6 months to limit the descent of the cerebellum tonsils and to prevent the turricephalic development; fronto-facial monobloc advancement with internal distraction around the age of 18 months in case of severe exorbitism or breathing impairment...
October 2016: Annales de Chirurgie Plastique et Esthétique
Dane J Genther, Ira D Papel
Rhinoplasty often requires the use of grafting material, and the goal of the specific graft dictates the ideal characteristics of the material to be used. An ideal material would be biologically inert, resistant to infection, noncarcinogenic, nondegradable, widely available, cost-effective, readily modifiable, and easily removable, have compatible biomechanical characteristics, retain physical properties over time, and not migrate. Unfortunately, no material currently in existence meets all of these criteria...
October 2016: Facial Plastic Surgery: FPS
Ozan Luay Abbas
BACKGROUND: Considering that revision rhinoplasty is one of the most difficult plastic surgical procedures, evaluating patient satisfaction is fundamental in order to determine success and identify variables that may affect the outcomes. Our first study objective was to determine satisfaction levels in revision patients and to compare results with those obtained in primary rhinoplasty patients. Second, we sought to identify factors that may influence the degree of satisfaction. METHODS: Satisfaction was evaluated in 54 revision and 54 primary rhinoplasty patients using the rhinoplasty outcome evaluation questionnaire...
2016: SpringerPlus
Arash Momeni, Ronald P Gruber
Rhinoplasty is perhaps the most complex cosmetic surgery procedure performed today. It is characterized by an intricate interplay between form and function, with patient satisfaction being dependent not only on improvement of nasal appearance but also resolution of preexisting airway symptoms. The prerequisite for successful execution of this challenging procedure is a thorough understanding of nasal anatomy and physiology. Hence, a thorough preoperative evaluation is at least as important and the surgical skill in performing the operation...
October 2016: Aesthetic Surgery Journal
Adem Topkara, Adem Özkan, Ramazan Hakan Özcan, Mustafa Öksüz, Metin Akbulut
BACKGROUND: Diced cartilage grafts are important in rhinoplasty for raising the dorsum and eliminating dorsal irregularities. The most common problems with the use of diced cartilage are wrapping and cartilage resorption. OBJECTIVES: To histopathologically investigate and compare the viability of diced cartilage grafts wrapped with concentrated growth factor, fascia and fenestrated fascia, or blood glue. METHODS: Cartilage grafts were harvested from the ears of 10 New Zealand White rabbits and diced into 0...
September 2, 2016: Aesthetic Surgery Journal
Seyed Esmail Hassanpour, Ataollah Heidari, Seyed Mehdi Moosavizadeh, Mohammad Reza Tarahomi, Ali Goljanian, Sanaz Tavakoli
BACKGROUND: Although the assignment and suturing of the spreader graft to the septum is a routine part of rhinoplasty, it is a time wasting procedure and some problems may occur. Rather, autospreader flap is a new method that the dorsal part of the upper lateral cartilage is used as its own graft. In the present study, we intended to compare the functional and aesthetic outcomes of these two techniques of rhinoplasty. METHODS: In a clinical trial, patients who referred to 15 Khordad Hospital for elective rhinoplasty during 2013-2014 were enrolled...
May 2016: World Journal of Plastic Surgery
Susie Lin, Yen-Chang Hsiao, Chun-Shin Chang, Philip Kuo-Ting Chen, Jyh-Ping Chen
Pure diced cartilage graft has been the technique of choice for revision rhinoplasty in cleft patients since 2003 at our center. This technique has several advantages over the traditional en bloc cartilage onlay graft including minimal risk of warping, its technical simplicity, and the ability to adjust the shape of the graft with manual massage for up to 3 weeks postoperatively. Calcification of the costal cartilage, however, poses a real concern for surgeons. In this case report, we are presenting a 64-year-old woman with a right unilateral complete cleft lip and palate deformity who presented to our clinic for secondary revision...
July 2016: Plastic and Reconstructive Surgery. Global Open
Wright A Jones
No abstract text is available yet for this article.
September 2016: Aesthetic Surgery Journal
Nazir A Khan, Ayaz Rehman, Rajshri Yadav
The surgeons performing rhinoplasty found Graft selection the greatest challenge. To avoid an immune response the preferred choice thus far for nasal reconstruction would be autograft compared to allograft due to its lower rate of rejection. We have evaluated 30 patients who underwent open rhinoplasty and We used conchal and septal cartilaginous grafts in various forms by the open approach to correct various nasal deformities compared our experience regarding the operative technique, graft availability, indications, and limitations...
September 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
Young-Eun Kim, Jihyeon Han, Rong-Min Baek, Baek-Kyu Kim
BACKGROUND: Optimal timing for cleft lip rhinoplasty is controversial. Definitive rhinoplasty is deferred until facial skeletal growth is completed. Intermediate rhinoplasty is performed after stabilization of the grafted alveolar bone, because the grafted bone tends to be absorbed over several months postoperatively, distorting the nasal profile. Here, we report our experience with simultaneous rhinoplasty during alveolar bone grafting for indicated patients, describe our surgical technique that ensures long-term bone graft survival, and report graft take rates and nasal profile changes...
July 25, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Milos Kovacevic, Frank Riedel, Abdülkadir Göksel, Jochen Wurm
Prevention of unfavorable sequelae following humpectomy in reduction rhinoplasty by restoration of the middle nasal vault complex today has become imperative in the majority of patients with perhaps the exception of small humps. In general, the techniques used for preservation and reconstruction of these important anatomical structures can be divided into two main categories: spreader graft and spreader flap techniques. Oversimplified spreader graft techniques require donor cartilage, whereas spreader flap techniques use the excess height of the medial portion of the upper lateral cartilages in patients with a cartilaginous hump...
August 2016: Facial Plastic Surgery: FPS
Fazil Apaydin
During rhinoplasty, the most stressful areas of the nasal cartilaginous septum are at the key area and anterior nasal spine. A stable fixation of the caudal septum to respond to these stresses is of utmost importance. The prerequisite for a successful fixation is a well-prepared recipient bed for caudal septum and suture fixation. The bed can be opened by using scissors, osteotome, or powered instrumentation. Simple or multiple sutures passing from the bone and/or surrounding soft tissues are used for fixation...
August 2016: Facial Plastic Surgery: FPS
Hossam M T Foda
The soft-tissue triangle is one of the least areas attended to in rhinoplasty. Any postoperative retraction, notching, or asymmetries of soft triangles can seriously affect the rhinoplasty outcome. A good understanding of the risk factors predisposing to soft triangle deformities is necessary to prevent such problems. The commonest risk factors in our study were the wide vertical domal angle between the lateral and intermediate crura, and the increased length of intermediate crus. Two types of soft triangle grafts were described to prevent and treat soft triangle deformities...
August 2016: Facial Plastic Surgery: FPS
Seung-No Hong, Somasundran Mutsumay, Hong Ryul Jin
Importance: Combined rhinoplasty and septal perforation repair is a technically challenging procedure, and few studies have reported the outcomes. Objective: To present the long-term surgical results of rhinoplasty with concurrent septal perforation repair. Design, Setting, and Participants: This retrospective study included 17 patients who underwent rhinoplasty with concurrent septal perforation repair at a tertiary academic medical center from March 2005, through March 2015...
August 4, 2016: JAMA Facial Plastic Surgery
Jordan P Farkas, Michael R Lee, Rod J Rohrich
BACKGROUND: Cartilage warping has plagued reconstructive and cosmetic rhinoplasty since the introduction of extraanatomical cartilage use. The authors' group theorized that, rather than focusing on the prevention of the innate tendency of rib graft warping, it may be possible to redirect the stressors toward themselves and use these forces with oppositional suturing techniques to compensate for these intrinsic characteristics. METHODS: Fresh cadaver cartilage was obtained from the costosternal junction of two rib cages (aged 77 and 99 years)...
August 2016: Plastic and Reconstructive Surgery
Bilge Turk Bilen, Goktekin Tenekeci
Thinness of nasal dorsum skin and subcutaneous tissue underlying nasal dorsal skin are the major factors related to the visibility of small irregularities. Here, the authors discuss the use of bare fragmented cartilage grafts in managing nasal dorsum and the results obtained.Eight hundred fifty-six patients were operated for rhinoplasty between September 2009 and September 2014. Fragmented cartilage grafting over the nasal dorsum was performed in 781 of 856 patients. In total, 214 patients who were followed up regularly were evaluated...
October 2016: Journal of Craniofacial Surgery
Ali Alper Bayram, Ahmet Erdem Kilavuz, Gediz Murat Serin
Structural deficiencies of the nasal dorsum are most commonly of congenital, traumatic, or iatrogenic etiology. Various grafts, including autografts, homografts, and synthetic materials, have been used to this end and are described in the literature.Autologous septal cartilage is the most commonly used graft material when limited augmentation rhinoplasty is planned. However, it is difficult to retain sufficient cartilage to allow of such augmentation in instances where most of the septal cartilage has been used...
October 2016: Journal of Craniofacial Surgery
Eric S Rosenberger, Dean M Toriumi
Revision rhinoplasty is a complex operation with many variables that may influence the final esthetic and functional outcome of the procedure. Cartilage forms the structural framework of the lower two-thirds of nose and is essential for long-term support and maintenance of a patent nasal airway. The use of autologous cartilage grafting is the primary source of this material, limited by donor site quantity, quality, and harvest morbidity. Alloplastic materials, solid and injectable, are often used for augmentation purposes and may have devastating consequences...
August 2016: Facial Plastic Surgery Clinics of North America
Fred G Fedok
Rhinoplasty is inherently a difficult procedure given the complexity of its structure and the functional and aesthetic impact of this anatomy. This report explores some of the remaining questions regarding the use of spreader grafts and autospreader flaps in the management of the middle vault in rhinoplasty, the performance of the open approach versus the endonasal rhinoplasty approach, corrective rhinoplasty in the younger patient, the use of the rib and other cartilage donor sites for grafting in rhinoplasty, and the use of filler materials in rhinoplasty...
August 2016: Facial Plastic Surgery Clinics of North America
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