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Sutures in rhinoplasty

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https://www.readbyqxmd.com/read/28746275/finesse-in-nasal-tip-refinement
#1
David A Sieber, Rod J Rohrich
Nasal tip refinement is one of the most difficult aspects of rhinoplasty surgery. In this article, the senior author (R.J.R.) presents his technique for nasal tip analysis and identifies the factors that contribute to nasal tip shape. Various techniques for nasal tip modification using both sutures and soft cartilage grafts are described to help produce optimal results.
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28639070/osseous-cartilaginous-spreader-graft-and-nasal-framework-reconstruction
#2
Safvet Ors
Revision rhinoplasties and saddle nose deformities usually require grafting for reconstruction. Between January 1, 2000, and January 1, 2017, autologous rib grafts were used in 127 secondary and tertiary rhinoplasty patients [(57/127 females) and (70/127 males)]. Osseous-cartilaginous rib grafts (OCRGs) were divided into three parts (i.e., 1/3 upper peripheral, 1/3 central, and 1/3 lower peripheral). The harvested OCRGs were also shaped as vertical strips using a number 11 scalpel blade. These OCRGs were shaped to form the L-strut cartilaginous graft (LSCGs), osseous-cartilaginous spreader grafts (OCSGs), osseous-cartilaginous onlay grafts, nasal valve grafts (NVGs), and lower lateral cartilaginous grafts (LLCGs)...
June 21, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28530250/the-hump-columellar-strut-a-reliable-technique-for-correction-of-nasal-tip-underprojection
#3
P G Giacomini, S Mocella, S Di Girolamo, R De Berardinis, A Boccieri
Nasal tip under projection is often found in rhinoplasty cases both for congenital or post-traumatic deformity. Nasal trauma may result in alteration of the external and internal nasal structures with following aesthetic impairment and difficulties in breathing. Post-traumatic surgery is frequent, but restoration of pre-traumatic form and function remains a challenge. The present paper describes a new method to increase tip projection by a columellar strut harvested from the autologous nasal bone and cartilage of the resected hump...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28529935/modified-fisher-method-for-unilateral-cleft-lip-report-of-cases
#4
Hui Young Kim, Joonhyoung Park, Ming-Chih Chang, In Seok Song, Byoung Moo Seo
BACKGROUND: Rehabilitation of normal function and form is essential in cleft lip repair. In 2005, Dr. David M. Fisher introduced an innovative method, named "an anatomical subunit approximation technique" in unilateral cleft lip repair. According to this method, circumferential incision along the columella on cleft side of the medial flap is continued to the planned top of the Cupid's bow in straight manner, which runs parallel to the unaffected philtral ridge. Usually, small inlet incision is needed to lengthen the medial flap...
December 2017: Maxillofacial Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28364534/three-dimensional-3d-columellar-strut-graft-in-rhinoplasty
#5
Adem Topkara
Background: Nasal tip surgery is the most important and most difficult step of an aesthetic rhinoplasty operation. Various suture and grafting techniques have been described for adequate tip rotation and projection in nasal tip surgery. Objectives: The author describes his technique of "three-dimensional (3D) columellar strut graft" in nasal tip surgery. Methods: Each patient is treated using the open technique rhinoplasty. The author's technique uses a 3D dorsal columellar strut with a special anatomy in the shape of a Y- on a horizontal plane...
April 1, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28273999/introducing-a-favourite-tip-definition-and-projection-with-tripod-suture-in-rhinoplasty
#6
Sadrollah Motamed, Hamidreza Alizadeh Otaghvar, Feizollah Niazi, Seyed Mehdi Moosavizadeh, Babak Motaghedi, Adnan Tizmaghz
INTRODUCTION: Surgical manipulation of the lower lateral cartilages of nasal tip could cause subtle but significant responses to the manipulation. The suture-techniques almost always offer a reliable and dramatic method of tip reshaping without a need to break or interrupt the alar rim strip or even adding tip graft. AIM: The aim of this study was to describe and assess outcomes of a new suture technique in rhinoplasty by using cephalic dome septal rotation suture for better tip definition...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28204928/advocating-the-use-of-absorbable-sutures-for-columellar-incisions-following-open-rhinoplasty
#7
I Beegun, H A Saleh
Rapidly absorbable skin sutures have been found to be of use in numerous settings including for the closure of the columellar incision following open rhinoplasty. Its removal does not routinely require trimming, and the sutures tend to fall off with minimal intervention 10-14 days postoperatively. This practice has a good acceptance by patients and utilises less resources in the follow-up period. Level of evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www...
February 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28150412/new-application-of-three-dimensional-printing-biomaterial-in-nasal-reconstruction
#8
Sun Hwa Park, Byeong Gon Yun, Joo Yun Won, Won Soo Yun, Jin Hyung Shim, Mi Hyun Lim, Do Hyun Kim, Sang A Baek, Yahya Dhafer Alahmari, Jun Ho Jeun, Se Hwan Hwang, Sung Won Kim
OBJECTIVES: Polycaprolactone (PCL) is an U.S. Food and Drug Administration-approved synthetic biodegradable polymer and is easily fabricated into three-dimensional (3D) structures. In this study, the 3D-printed PCL implant for nasal augmentation was further evaluated for its suitability for nasal surgeries such as septoplasty and rhinoplasty. METHODS: Ten New Zealand White rabbits were included and divided into study and sham groups (7 and 3, respectively). A lateral incision was made on the nasal dorsum and a pocket formed in the subperichondrial plane between the upper lateral cartilage and nasal septum...
May 2017: Laryngoscope
https://www.readbyqxmd.com/read/28127662/an-effective-algorithm-for-management-of-noses-with-thick-skin
#9
Bahman Guyuron, Michelle Lee
BACKGROUND: Thicker nasal skin blunts the definition of the underlying osseocartilaginous frame and the delicate topography of the nose posing additional challenges in producing desirable tip definition. Despite the recognized challenge in this patient population, there is a paucity of literature on how to overcome this problem. PURPOSE: The goal of this article is to provide a systematic algorithm to manage patients with thick nasal skin. METHOD: Approach to the thick nasal skin patient begins with an evaluation of the etiology of their skin thickness...
April 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28033644/dome-division-a-viable-technique-today
#10
Armando Boccieri, Sebastiano Sciuto, Valerio Cervelli, Michele Pascali
Dome division can still be regarded as a valid surgical procedure today in some particular cases of revision rhinoplasty where the scarring is so extensive as to make precise isolation of the alar cartilages impossible. The presence of asymmetry of the nasal tip, a recurrent feature in the results of rhinoplasty, constitutes the primary indication, as division makes it immediately possible to restore balance between the two domes in such cases. The technique also proves useful in cases of overprojection of the tip as a result of rhinoplasty...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28033642/isotretinoin-use-in-thick-skinned-rhinoplasty-patients
#11
Roxana Cobo, Liliana Vitery
One of the characteristics of mestizo patients can be the thick sebaceous skin associated with a poor osteocartilaginous underlying nasal structure. In spite of using a proper structural approach where grafts and sutures are used to define the nasal tip, frequently the results are suboptimal. Surgical techniques have been described to reduce the thickness of the skin-soft tissue envelope, but these frequently give unreliable results. The monitored use of isotretinoin given orally as a complement after performing a rhinoplasty can adequately control the production of the sebaceous glands and thin the skin-subcutaneous tissue envelope in a uniform fashion without compromising the underlying bony and cartilaginous structures of the nose...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28033632/aesthetic-rhinoplasty-as-a-surface-contour-operation-from-analysis-to-surgery-personal-concepts
#12
Palma Pietro, Khodaei Iman, Vasilenko Irina
Numerous beautiful rhinoplasty results have been created by closed rhinoplasty techniques over the past 100 years. This operation was mainly a "reduction" surgery. Overaggressive reduction rhinoplasty is not a hallmark of the closed approach per se, but represents the result of inappropriate aesthetic appraisal, inadequate technical execution, or lack of sound anatomical understanding. Clearly, an operation based primarily on reduction intrinsically exposes the surgeon to the possibility of excessive diminution of support structures and consequently undesirable side effects...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28032172/effects-of-the-rhinoplasty-maneuvers-on-upper-lip-position-and-incisor-show
#13
Hongyang Pi, David E Kurlander, Bahman Guyuron
BACKGROUND: Smiling involves dynamic movements that include nasal tip descent and upper lip ascent. The effect of rhinoplasty on upper lip position is poorly described. METHODS: One hundred charts were reviewed in reverse chronologic order. Inclusion criteria were receiving one of the rhinoplasty maneuvers of interest, at least 6 months of follow-up, and pre- and postoperative photographs by a professional medical photographer with matching maximum smile extent and size...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28032151/the-effect-of-the-short-and-floating-columellar-strut-graft-and-septocolumellar-suture-on-nasal-tip-projection-and-rotation-in-primary-open-approach-rhinoplasty
#14
Hakan Şirinoğlu
OBJECTIVE: The maintenance of desired tip projection and rotation is an important goal in rhinoplasty. In this study, the effects of the columellar strut graft and septocolumellar sutures were evaluated in a follow-up period of 1 year. PATIENTS AND METHODS: In half of 44 patients, nasal tip was constructed with basic tip maneuvers and two septocolumellar sutures (Group-1, Suture Group), whereas in the remaining 22 patients, a columellar strut graft was added for tip support (Group-2, Suture + Graft Group)...
February 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/27845961/lateral-crural-reinforcement-in-secondary-cleft-lip-nasal-deformity-through-a-combined-lateral-crural-turn-over-flap-and-strut-graft
#15
Jihyeon Han, Rong-Min Baek, Baek-Kyu Kim
BACKGROUND: Secondary cleft lip nasal deformity is a complex deformity, and the variety of recommended techniques used to correct this deformity attests to it. Much of the nasal deformity can be attributed to an abnormal lower lateral cartilage. This study presents our experience with applying a lateral crural turnover flap with a sandwiched strut graft in adjunct with other procedures to correct unilateral secondary cleft lip nasal deformity. METHODS: A retrospective review was conducted of 20 cases of unilateral cleft lip patients undergoing secondary rhinoplasty with lateral crural turnover flap with strut graft...
July 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27826459/reinserting-the-hump-in-primary-rhinoplasty-the-gain-is-three-fold
#16
Jannis Constantinidis, Georgios Fyrmpas
BACKGROUND: Hump reduction in aesthetic rhinoplasty destabilizes the middle vault. Secondary maneuvers are necessary to avoid the long-term functional and aesthetic sequelae of middle vault collapse. We describe a new technique of reinserting the resected hump that combines (a) placement of the modified hump between the upper laterals and (b) bridging sutures between the upper laterals. METHODS: Retrospective review of patients undergoing primary aesthetic rhinoplasty with hump resection...
October 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27680529/modified-endonasal-tongue-in-groove-technique
#17
Sameep Kadakia, Alexander Ovchinsky
UNLABELLED: Achieving stable and desirable changes in tip rotation (TR) and tip projection (TP) is among the primary goals of modern day rhinoplasty. The tongue-in-groove (TIG) technique is one technique in rhinoplasty used to improve TR and/or TP. Performing TIG endonasally using a permanent suture can be quite cumbersome as the suture needs to be buried under the skin. We describe a variation of TIG technique for endonasal rhinoplasty using a permanent suture buried in small columellar skin incisions...
October 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/27622086/interdomal-suture-through-a-nondelivery-endonasal-approach-a-new-technique
#18
Marcos Harel, Lior Leibou
BACKGROUND: The use of interdomal sutures for tip refinement is common in open rhinoplasty and in endonasal rhinoplasty using a delivery technique, but there is paucity of reports in the literature regarding the use of interdomal suturing techniques when the nondelivery endonasal approach is chosen. OBJECTIVE: The authors describe a technique designed to refine the nasal tip with an interdomal suture placed through a nondelivery endonasal approach. METHODS: In this study, the authors retrospectively review the cases of 45 patients who underwent endonasal rhinoplasty with the authors' interdomal suturing technique between the years 2011 and 2013...
August 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27585247/objective-comparison-of-nasal-tip-contours-in-the-basal-view-between-dome-binding-and-hemitransdomal-tip-suture-techniques-in-rhinoplasty
#19
COMPARATIVE STUDY
Fernando Casanueva, Deniz Gerecci
Importance: The dome binding suture (DBS) used for nasal tip refinement creates the unwanted effects of nasal tip pinching owing to shadowing and loss of alar support. The hemitransdomal suture (HTS), however, refines the nasal tip while maintaining a natural contour between the nasal tip and the alar lobule. To our knowledge, no objective comparison between the DBS and HTS techniques has been described in the literature to date. Objective: To determine whether the DBS or HTS technique results in an objectively satisfactory outcome in nasal tip contouring when assessed from the perspective of the basal view...
December 1, 2016: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/27579268/comparison-of-aesthetic-and-functional-outcomes-of-spreader-graft-and-autospreader-flap-in-rhinoplasty
#20
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
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