Showing 47 results for Rhinoplasty
Mohamad Reza Afzalzadeh, Ali Alizadeh,
Volume 12, Issue 3 (10-2023)
Abstract
The achievement of best outcome in rhinoplasty is very important for both of the patients and plastic surgeons. Since the skin characteristics (e.g. nasal thickness and sebaceous hypertrophy) has clear role on the result, many related interventions have been proposed in recent decades to gain an appropriate result. Accordingly, isotretinoin firstly introduced to treat some type of acne, has been suggested controversially to be used in rhinoplasty. Although the early uncertain studies implied on its side effects, the recent more powerful studies and evidences indicate that isotretinoin is remarkably effective to obtain proper outcome. Nevertheless, its prescription to patients need to be evaluated and personalized. More discussion on this regard are presented in the text.
Masoud Saman, Alireza Sharifi,
Volume 13, Issue 1 (1-2024)
Abstract
Abstract
Background: The safety and outcomes of performing a simultaneous Alar reduction, Lip lift, and Open rhinoplasty Surgery (ALOS) through independent incisions have not been reported in any study, therefore, we aimed to evaluate the safety and outcomes of this combination procedure.
Methods: This retrospective review study was conducted on all cases of simultaneous ALOS, lip-lift, and alar reduction performed from 2018-2022, at Facial Plastic Surgery Clinic, New York, USA. Alar reduction involved complete through-and-through resection of alar wedge, and the type of lip lift technique was bullhorn design with excision of skin and Superficial Musculo-Aponeurotic System. Primary open rhinoplasty with inverted V-columellar incision was performed. The follow up period ranged between 4 months to 2 years, but all of patients were followed up at 6 days, one, and two months post-operatively.
Results: Fifty one cases were enrolled. We reviewed criteria of complications including infection, vascular events (such as necrosis, or partial ischemia), and poor scarring, fortunately, we did not have any infection or vascular issues. In 2 cases, columellar scar was “less than optimal”, but in all other cases, this scar was “not perceivable” based on the patient survey. In 4 cases, the lip lift procedure scar was considered “less than optimal” showed slight indentation of white scar of lip lift in 9/44 cases. Additionally, all columellar and alar incisions had nearly invisible scarring.
Conclusion: In primary rhinoplasty cases, without any other surgeries or previous trauma in the oronasal region, performing concomitant lip lift, open rhinoplasty, and alar wedge resection is safe and does not negatively affect vascularity or scarring.
Ali Goljanian Tabrizi, Matin Ghazizadeh, Zahra Rootivand,
Volume 13, Issue 1 (1-2024)
Abstract
Background: Rhinoplasty has become a globally prevalent esthetic procedure, necessitating precise facial analysis and comprehensive preoperative planning for favorable postoperative outcomes. We aimed to assess patient satisfaction levels concerning nasal appearance following rhinoplasty.
Methods: A case series interventional study was conducted involving 52 subjects referred to Rhinoplasty Clinics of Taleghani Hospital, Tehran, Iran from Mar 2021 to Mar 2022. Patients' satisfaction levels were evaluated using a concise checklist before and three months after surgery.
Results: The mean age of the patients was 29.23 ± 7.26 years, with 19 (36.5%) being male. Statistically significant improvements were observed in all assessed factors, including nasal obstruction, nasal size, hump presence, nasal bridge width, nasal tip bulbosity, nasal deviation, radix, nostril asymmetry, and tip ptosis (P < 0.001). These findings reveal a consistent pattern of patients' satisfaction levels predominantly shifting from moderate to low across various aspects of nasal appearance post-rhinoplasty.
Conclusion: The study demonstrated a significant enhancement in patients' satisfaction with their nasal appearance following rhinoplasty, indicated by statistically significant changes across all assessed factors. However, certain aspects exhibit more limited enhancement.
Hamidreza Rastiboroujeni , Mehdi Bakhshaee , Mohamad Reza Afzalzadeh , Yalda Nahidi,
Volume 13, Issue 1 (1-2024)
Abstract
Background: Despite the increasing popularity of cosmetic surgeries, some patients still experience skin problems, particularly those with thick nasal skin. Isotretinoin is a commonly used drug for severe acne, and its effects on rhinoplasty aesthetic results have recently been studied. This placebo-controlled clinical trial aimed to investigate the effects of topical tretinoin gel on the cosmetic outcomes of rhinoplasty in patients with thick nasal skin.
Methods: Forty-nine individuals were randomly allocated to either the treatment group or the control group in Mashhad, Iran from 2019 to 2021. The treatment group received topical tretinoin gel (0.05%) beginning on the 31st postoperative day and continued for six months, while the control group received a usual dermatological recommendation as a placebo. Patients were assessed during the first, third, and sixth months after the intervention, and their cosmetic results were evaluated by an expert surgeon and dermatologist.
Results: There were no significant differences in baseline features between the two groups. The median score given by the surgeon was not significantly different between the groups. However, the median score given by the dermatologist was significantly higher in the treatment group during the first, third, and sixth months (P<0.001). Patient satisfaction scores were also significantly higher in the treatment group during the third and sixth months compared to the control group. (P=0.02 and 0.01, respectively).
Conclusion: Topical tretinoin gel could effectively reduce acne in patients with thick nasal skin after rhinoplasty and increase patient satisfaction in the early months following surgery. However, it did not significantly affect final cosmetic outcomes.
Ershad Hemmati, Razieh Moaref Pour, Mahdis Masudrad, Mozhgan Sametzade,
Volume 13, Issue 1 (1-2024)
Abstract
Background: We aimed to compare the effect of two low to high lateral osteotomy methods, percutaneous and internal on the tear trough and scleral show in patients undergoing esthetic open rhinoplasty.
Methods: This prospective single-blind randomized clinical trial study was conducted on 80 patients in two groups of 40 candidates for rhinoplasty surgery referred to Imam Khomeini Hospital in Ahvaz, southern Iran in 2021. In the first group, lateral osteotomy was performed internally and in the other group, percutaneously. Then, the changes in tear trough and scleral show before surgery, one and three months after surgery were compared between two groups.
Results: The median of the medial limbus in the percutaneous group was about 0.38 higher than the internal group, but no significant difference was observed (P=0.322). Moreover, the median medial canthus in the percutaneous group compared to the internal group had no statistically significant difference (P=0.163). There was no significant difference in the average lateral limbus changes between the two groups (P=0.389). The median scleral show in all times before surgery, one and three months after surgery in the percutaneous group was higher than in the internal group, but the differences were not significant. In addition, the median scleral show changes before and three months after surgery in the percutaneous group were not remarkably different from the internal group (P=0.290).
Conclusion: Both techniques are almost similar in terms of periorbital effect after surgery in the early stages and 3 months after surgery. More multicenter studies with higher sample size and longer follow-up period seem necessary.
Gholamreza Motazedian, Parsa Yazdanphanahi, Ebtesam Jabbarinia, Ali Kaviani, Fateme Salari, Farnaz Atighi, Mohammadreza Keshtkar, Alireza Keshtkar,
Volume 13, Issue 2 (5-2024)
Abstract
Background: Considering the importance of the nose in the beauty of the face, accurate and systematic three-dimensional nasal analysis of the nose before the procedure is essential. The radix, and so the nasofrontal and nasofacial angles, play an essential role in forming an aesthetically pleasing nose because they influence the length and projection of the nose. We aimed to measure information about the pre-operative radix position in our region.
Method: Pre-operative images were taken from our cases in the profile view. A checklist including radix location and projection, nasofrontal angle, and nasofacial angle were extracted from these images.
Results: Overall, 200 (100 males and 100 females) cases were enrolled. Thirty-two male cases and 48 females had abnormal radix position. Radix projection were normal in only 36 male cases and 18 females. The mean nasofrontal angle in the male and female groups was 119.2 and 128.2 respectively. The mean nasofacial angle was 29.8 in the female groups and 32.6 in the male group.
Conclusion: The reality of the current society of Iranian patients can be very different from the predictions of surgeons and can be far away from the statistics mentioned in western books. We tried to notify surgeons to thoroughly examine the patients prior to surgical operation by measuring parameters such as projection and position of the radix and nasofrontal and nasofacial angles.
Mehrdad Adibparsa, Mina Ghazavi, Hamidreza Shetabi,
Volume 13, Issue 3 (11-2024)
Abstract
Background: Hemorrhage during rhinoplasty may impair the surgeon's visibility.. Our objective was to examine the impact of subcutaneously administered Tranexamic acid (TXA) on bleeding during rhinoplasty.
Methods: A three-blind randomized clinical trial including 60 patients undergoing nose surgery was conducted to compare the effects of two different anesthetic solutions on surgery results. The control group received a solution consisting of 5 cc of 2% lidocaine and 0.5 cc of epinephrine, and the TXA group received a solution containing 5 ml of 2 lidocaine, 0.25 cc of epinephrine and 4.75 cc of 10% TXA. To achieve a total injection volume of 10 ml in both groups, distilled water was added. Bleeding rate, hemodynamic parameters, surgeon satisfaction and overall quality of the surgical field were evaluated.
Results: The hemodynamic parameters exhibited no notable differences between the two groups throughout the study period (P value > 0.05). The volume of bleeding observed in the TXA group was marginally greater than that in the control group (P value=0.061). Additionally, there were no significant variations in the quality of the surgical field or the satisfaction levels of the surgeon between the two groups.
Conclusion: In the TXA group, there was no increase in bleeding despite using a low concentration of epinephrine. Consequently, it is recommended that an injectable formulation of TXA containing a reduced concentration of epinephrine be used in surgical procedures where the use of high-concentration epinephrine is contraindicated, such as in patients with cardiovascular disease.
