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Grafts in rhinoplasty

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https://www.readbyqxmd.com/read/28072550/rotational-advancement-in-cleft-nose-rhinoplasty-buccal-mucosal-grafts-serve-as-a-powerful-tool
#1
Andreas Kehrer, Tim H J Nijhuis, Pál Pesthy, Sten Willemsen, René Poublon, Jacques J J N M van der Meulen
OBJECTIVE:   Our aim was to analyze our technique of a modified rotational advancement in conjunction with buccal mucosal grafts (BMGs) in a subgroup of severe cleft cases. DESIGN:   A retrospective clinical and photographic evaluation was conducted. Columella angle (CA) and tip projection (TPR) served as instruments in a photometric analysis. SETTING:   Academic university hospital and specialized craniofacial cleft center. PATIENTS:   At the time of the secondary rhinoplasty, 61 cleft patients were included, all 17 years or older...
January 10, 2017: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/28062967/septal-cartilage-ethmoid-bone-composite-graft-a-new-and-improved-method-for-the-correction-underdeveloped-nasal-septum-in-patients-with-short-noses
#2
Soo Hyang Lee, Mun Geun Koo, Eun Taek Kang
BACKGROUND: Septal extension grafts are an effective means of extending nasal length in patients with a short nose. However, such grafts can be challenging in patients who only have small quantities of weak septal cartilage, such as some East Asian patients. We developed a rhinoplasty technique using ethmoid bone to create a cartilage-bone complex to overcome this issue, allowing adequate nasal lengthening. METHODS: Sixty-four women with short noses and inadequate septal cartilage determined by preoperative computed tomography underwent septal extension grafting with a cartilage-bone complex between January 2009 and December 2014...
January 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28034843/the-effect-of-nasal-tip-rotation-on-upper-lip-length
#3
Kevin Perkins, Ajul Shah, Anup Patel, Derek Steinbacher
BACKGROUND: Increasing the nasolabial angle (NLA) with tip rotation generates the appearance of a lengthened lower facial third. In particular, the upper lip show seems increased following elevation of the nasal tip. OBJECTIVES: The purpose of this study is to quantify the impact of tip rotation on upper lip length (ULL), and to establish a predictable correlation between the two. METHODS: A retrospective cohort study of rhinoplasty patients with increased tip rotation, using either caudal septal extension graft (CSEG) or columellar strut graft (CS), was performed...
December 29, 2016: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28033642/isotretinoin-use-in-thick-skinned-rhinoplasty-patients
#4
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/28033641/optimizing-the-soft-tissue-triangle-alar-margin-furrow-and-alar-ridge-aesthetics-analysis-and-use-of-the-articulate-alar-rim-graft
#5
Jennifer L Goodrich, B J F Wong
The alar lobule, alar margin, and soft triangle facet are receiving more attention in the literature as critical elements to address both preoperatively and during rhinoplasty. We have found that the use of the articulated alar rim graft (AARG) corrects deficiencies in these areas as well as provides mechanical stability to the external valve. In this article, we describe indications for AARG, describe in detail the procedure for AARG placement, and highlight the transformation AARGs can achieve in two illustrated case studies...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28033640/rebuilding-the-middle-vault-in-rhinoplasty-a-new-classification-of-spreader-flaps-grafts
#6
Fazil Apaydin
After hump removal in reduction rhinoplasty, one of the main steps is to rebuild the middle vault. Spreader grafts have long been the main tool for the surgeon. Within the last two decades, the spreader flaps have started to be very popular as well. In accordance with the experience and technical preferences of the surgeon, there are many different options. In this article, the spreader grafts are classified as traditional, modified, splinting, and reconstructive. The spreader flaps are designed in accordance with their relationship with the septum and the spreader grafts...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28033636/treatment-strategy-for-revision-rhinoplasty-in-asians
#7
Yong Ju Jang, Do-Youn Kim
Revision rhinoplasty in Asian patients is associated with problems related to the use of grafts or implant materials. Moreover, the septal cartilage of Asian individuals is generally weak and small, which makes it particularly vulnerable to injury or secondary deformity during primary surgery. Hence, there is an increased demand for major reconstruction of the septal cartilage framework during revision surgery in Asian patients. In revision rhinoplasty of the nose in Asian patients, appropriate management of the graft or implant is vital...
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
#8
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
#9
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/28032171/iatrogenic-through-and-through-conchal-defect-secondary-to-auricular-cartilage-graft
#10
Hyung-Suk Ro, Si-Gyun Roh, Jin Yong Shin, Nae-Ho Lee, Kyung-Moo Yang
BACKGROUND: Over the past few years, conchal cartilage has been most often used in rhinoplasty. The donor site complications following conchal cartilage graft harvesting are scar formation, hematoma formation, and delayed wound healing, although hematoma is one of the most important and common complications. A complete conchal defect as a complication of auricular cartilage graft harvesting has not been previously reported in the literature. The authors report an unusual case of an iatrogenic conchal defect resulting from conchal cartilage graft harvesting that was treated using a posterior auricular island flap...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28032162/a-practical-technique-for-reduction-of-the-bony-nasal-dorsum-height-using-kazanjian-bone-cutting-forceps
#11
Yalcin Yontar, Sedat Tatar
BACKGROUND: Resection of the nasal hump is one of the most critical steps of the rhinoplasty procedure, which is quite prone to complications when performed improperly or inappropriately. In this article, a practical, facile and minimally traumatic hump resection technique using Kazanjian bone-cutting forceps is presented with excellent cosmetic and functional results. METHODS: Fifty-seven consecutive primary (septo-)rhinoplasty patients with wide nasal bases, and various sizes of nasal humps, were enrolled in the study...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28032158/dorsal-onlay-with-diced-homologous-processed-rib-cartilage-grafts
#12
Peter J F M Lohuis, Anil Joshi, Gregor M Bran, Frank R Datema, Lenka Vermeeren
BACKGROUND: Diced cartilage wrapped in fascia or modeled with tissue sealant has successfully been used as dorsal onlay grafts in rhinoplasty. The use of autologous material introduces the risk of donor site morbidity, and sometimes availability is limited. METHODS: We present a series of nine cases that were performed using diced irradiated homologous rib cartilage as an onlay graft. RESULTS: Good functional and cosmetic outcomes were achieved in all nine patients, and no significant resorption was seen after a mean follow-up of 20 months...
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
#13
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)...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28012510/pediatric-rhinoplasty-a-discussion-of-perioperative-considerations-and-systematic-review
#14
Amar Gupta, Peter F Svider, Hani Rayess, Anthony Sheyn, Adam J Folbe, Jean Anderson Eloy, Giancarlo Zuliani, Michael A Carron
OBJECTIVES: Pediatric rhinoplasty has traditionally raised numerous concerns, including its impact on growth as well as the psychological sequelae of undergoing a potentially appearance-altering procedure. Our objective was to critically evaluate available individual patient data relevant to pediatric rhinoplasty, and further discuss perioperative considerations. METHODS: A systematic review was conducted using PubMed/MEDLINE databases. Data extracted and analyzed from included studies included patient demographics, surgical indications, operative approaches, outcomes, complications, revision rates, and other clinical considerations...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27983903/analyses-and-classification-of-complexities-in-rhinoplasties-based-on-factors-increasing-the-difficulty-and-their-appropriate-reconstruction
#15
Aret Çerçi Özkan, Ahmet Mert Bilgili, Erdem Güven
OBJECTIVES: This study aims to classify the factors that make rhinoplasty difficult and appropriate reconstruction of it. PATIENTS AND METHODS: We retrospectively evaluated the records of 103 patients who underwent rhinoplasty at our private clinic between April 2002 and December 2014. The most important reagent affecting the degree of difficulty in our study was the adhesion of the bone and cartilaginous structures to the skin and mucosa, as an outcome of on previous operations...
November 2016: Kulak Burun Boğaz Ihtisas Dergisi: KBB, Journal of Ear, Nose, and Throat
https://www.readbyqxmd.com/read/27978568/reconstructive-techniques-for-the-saddle-nose-deformity-in-granulomatosis-with-polyangiitis-a-systematic-review
#16
Waleed H Ezzat, Rebecca A Compton, Krystyne C Basa, Jessica Levi
Importance: Repairing the saddle nose deformity in the setting of granulomatosis with polyangiitis disease is a rare but challenging situation for any surgeon. Given that the available data in the literature is based on case reports and small case series, there is little evidence available to help delineate which reconstructive techniques are optimal. Objective: To examine which techniques were most successful in reconstructive rhinoplasty for a saddle nose deformity secondary to granulomatosis with polyangiitis...
December 15, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27922895/a-systematized-strategy-in-corrective-rhinoplasty-for-the-asian-deviated-nose
#17
Yong-Ha Kim, Chang Young Jung, Kyu Jin Chung, Jun Ho Lee, Tae Gon Kim
BACKGROUND: A deviated nose is a common deformity encountered in rhinoplasty. Over the past several decades, a variety of rhinoplasty techniques have been described focusing on the classification of bony and cartilaginous deviation. Nevertheless, corrective rhinoplasty is still a challenging procedure even for experienced surgeons because of the high recurrence rate of deviation. In attempt to reduce the recurrence rate, the author systematized the complex procedures by using a single technique regardless of the classification of a deviation...
December 5, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27896189/simple-correction-of-alar-retraction-by-conchal-cartilage-extension-grafts
#18
Yong Jun Jang, Sung Min Kim, Dae Hyun Lew, Seung Yong Song
BACKGROUND: Alar retraction is a challenging condition in rhinoplasty marked by exaggerated nostril exposure and awkwardness. Although various methods for correcting alar retraction have been introduced, none is without drawbacks. Herein, we report a simple procedure that is both effective and safe for correcting alar retraction using only conchal cartilage grafting. METHODS: Between August 2007 and August 2009, 18 patients underwent conchal cartilage extension grafting to correct alar retraction...
November 2016: Archives of 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
#19
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...
November 15, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27832272/use-of-costal-perichondrium-as-an-interpositional-graft-for-septal-perforation-closure
#20
Dean M Toriumi, Quintin M Cappelle, Victor Chung
Importance: Closure of septal perforations remains a technically difficult procedure to perform. Objective: To assess the use of costal perichondrium as an interpositional graft to enhance closure of septal perforations using bilateral mucosal flaps and the effectiveness of the procedure. Design, Setting, and Participants: This case series included all 51 consecutive patients presenting with septal perforations from January 1, 2006, to August 31, 2014, at a single institution...
November 10, 2016: JAMA Facial Plastic Surgery
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