Showing 47 results for Rhinoplasty
Abdoljalil Kalantar Hormozi, Seyed Reza Rafei,
Volume 1, Issue 1 (1-2012)
Abstract
Rhinoplasty is one of the most common aesthetic procedures in the world. It is the most common aesthetic surgery procedure in Iran. Achieving complete patient satisfaction is almost impossible but improving the aesthetics and function of the nose is the aim of surgery. This report describes a 34 years old woman with a large bump in the tip of the nose after three times cosmetic rhinoplasties. The first time was done 4 years before referral to our center as a reduction rhinoplasty operation. The next two subsequent surgeries were performed for revision and correcting the dorsal irregularities and supra tip bulge.
Unfortunately the supratip bulge persisted and subsequent subcutaneous injections of corticosteroids and fibrinolysin were carried out. She developed a bulbous tip nose deformity. Therefore, after a few months she was referred to our center. Surgical exploration showed a lesion in the supratip region and histopathologic examination showed a foreign body reaction and granuloma formation.
Ahmet Seyhan,
Volume 1, Issue 2 (7-2012)
Abstract
In crooked noses, the lateral walls are different in shape and symmetry. Although the septum is very important to obtain a straight nose, identical and symmetrical lateral walls are needed for a straight looking nasal dorsum. As well as the septum, lateral walls also contribute in nasal skeletal support and stability. Thus, obtaining identical and symmetrical lateral walls is important. In order to obtain symmetrical and stable lateral walls, the requirements are to equalize the height, to set in a symmetric location and finally to stabilize the symmetry. These requirements must be taken into consideration while performing the steps of rhinoplasty, namely, hump resection, osteotomies and stabilization by spreader grafts or flaps. Here, we describe the management of the lateral walls in crooked nose in 7 cases.
Ali Manafi, Amir Eslami Shahr Babaki, Golnoush Mehrabani, Abtine Shahlaee, Amir Manafi,
Volume 2, Issue 1 (1-2013)
Abstract
BACKGROUND
The ala of the nose, with its particular texture and characteristics, poses both aesthetically and functionally intriguing challenges and is rather problematic regarding choices for reconstructive methods. Both flaps and grafts have been used to restore natural structure of nasal ala. The present study summarizes a ten-year experience of reconstructive surgery using small composite grafts from non-cartilage bearing tissues, and large composite grafts, containing cartilaginous tissue, with a mean follow-up of 4 years and 8 months.
METHODS
Cumulatively 56 patients were reported. Some of them required surgery due to previous cosmetic rhinoplasty. In 47 of the cases, a small graft from the non-cartilage bearing junction of ear lobule to helical rim sufficed. Nine patients had rather large defects for which grafts were harvested from the helical root. Donor sites were primarily closed and grafts were implanted in place in a single, rapid session.
RESULTS
All small grafts had excellent take. Of 9 large grafts, 5 had excellent take, three had acceptable, and one, in a male smoker, failed to take. During follow-up, no gross deformity or poor scar was detected in either donor or recipient site.
CONCLUSIONS
We have demonstrated that using both large and small auricular composite grafts has favorable long term results for reconstruction of alar rim deformities. However, use of small grafts seems more beneficial and applicability of large grafts requires further studies.
Mahmoud Omranifard, Hosein Abdali, Mehdi Rasti Ardakani, Amiryousef Ahmadnia,
Volume 2, Issue 2 (7-2013)
Abstract
BACKGROUND
Nasal valve collapse and especially internal nasal valve insufficiency is a common cause of nasal airway obstruction. This study compares the effects of spreader graft and overlapping lateral crural technique on rhinoplasty by rhinomanometry.
METHODS
Fifty patients were randomly assigned into two groups and underwent spreader graft or overlapping lateral crural technique. Objective assessment was performed by clinical examination and rhinomanometry before and after rhinoplasty.
RESULTS
Nasal obstruction had no significant difference before and after rhinoplasty and no significant difference was observed between surgical techniques. Right, left and total nasal flow and resistance were different before and after surgery but were not significant. Base of the nose was not significantly different between two groups, but nasal projection was 2 mm in the the group who underwent overlapping lateral crura technique and the difference was statistically significant. Our study showed that both overlapping lateral crura and spreader graft technique were beneficial in rhinoplasty and they could provide enough internal nasal valve support. The overlapping lateral crura was an appropriate surgical technique for tip projection in comparison to spreader graft.
CONCLUSION
The overlapping lateral crura technique was shown to be a better surgical way for tip projection in comparison to spreader graft.
Muhammad Humayun Mohmand, Muhammad Ahmad,
Volume 3, Issue 1 (1-2014)
Abstract
BACKGROUND
According to statistics of American Society of Plastic Surgeons, cosmetic rhinoplasty was the second most frequently performed cosmetic surgery. This study shares the experiences with component rhinoplasty.
METHODS
From 2004 to 2010, all patients underwent aesthetic nasal surgery were enrolled. The patients requiring only correction of septal deviation and those presenting with cleft lip nasal deformity were excluded. All procedures were performed under general anaesthesia with open technique using transcolumellar and infra-cartilageous incisions. The transculomelalr incision was closed with 6-0 polypropylene and infra-cartilagenous incisions by 5-0 absorbable sutures. Non-absorbable sutures were removed on the fifth postoperative day. The septum was fixed by ‘quilting sutures’. Both nostrils were packed with antibiotic ointment containing paraffin gauzes which were removed after 24-48 hours. External nasal splint was applied to be removed on the fifth postoperative day.
RESULTS
A total of 191 patients were enrolled (male:female ratio=1:1.47). The mean age of female patients was 25.3 years and 29.4 years in males. Among 50.8% of patients, the cause of deformity was not known. Only 21.5% patients had a positive history of trauma. Majority of patients (90.6%) underwent septoplasty. Twenty percent of surgeries were secondary. Spreader grafts were used in 85% of patients. In 11% of patients, conchal grafts were used. For none of patients, the inferior turbinectomy was performed. No case of costal cartilage graft or silicone implant was used. Only 5.6% of patients had redo-surgeries. No abnormal scarring was noted during follow-up.
CONCLUSIONS
Dorsal hump reduction can be recommended with accuracy and safety without compromising the nasal airway.
Seyed Esmail Hassanpour, Seyed Mehdi Moosavizadeh, Mohsen Fadaei Araghi, Bahram Eshraghi,
Volume 3, Issue 2 (7-2014)
Abstract
BACKGROUND
The nasal septal deviation (NSD) is one of the major causes of nasal obstruction. This condition increases upper airway resistance. In This study we evaluated the mean pulmonary artery pressure (MPAP) in patients with markedly deviated septum.
METHODS
Sixty two patients with NSD (Age range: 26-45 years, 34 men and 28 women) were included in the study. Mean pulmonary artery pressure was measured in preoperative period by Doppler echocardiography with the assistance of an expert cardiologist.
RESULTS
The mean preoperative MPAP value (22.5 mmHg in men and 20.03 mmHg in women) of the patients in this study was higher than normal population (20 mmHg). The MPAP of nine patients (14.5%) was greater than 25 mmHg. This value was significantly higher than values for normal population.
CONCLUSION
Markedly deviated septum had improper effects in cardiovascular system due to increase in MPAP.
Ahmad Tavassoli Ashrafi,
Volume 3, Issue 2 (7-2014)
Abstract
BACKGROUND
Handling of upper lateral cartilages (ULCs) is of prime importance in rhinoplasty. This study presents the experiences among 2500 cases of rhinoplasty in the past 10 years for managing of ULCs to minimize unwilling results of the shape and functional problems of the nose.
METHODS
All cases of rhinoplasties were done by the same surgeon from 2002 to 2013. Management of ULCs changed from resection to preserving the ULCs and to enhance their structural and functional roles. The techniques were spreader grafts, suturing of ULC together at the level or above the septum, using ULCs as auto-spreader flaps and very rarely trimming of ULCs unilaterally or bilaterally for making symmetric dorsal aesthetic lines. Fifty cases were operated based on this classification. Most cases were in type II and III. There were 7 cases in type I and 8 cases in type IV.
RESULTS
Among most cases, the results were satisfactory although there were 8 cases for revision and among them, 2 cases had some fullness on dorsum and supra-tip because of inappropriate judgment on keeping the relationship between dorsum and tip. The problems in the shape and airways role of the nose reduced dramatically and a useful algorithm was presented.
CONCLUSION
ULCs have great important roles in shape and function of nose. Preserving methods to keep these structures are of importance in surgical treatments of primary rhinoplasties. The presented algorithm helps to manage the ULCs in different anatomic types of the noses especially for surgeons who are in learning curve period.
Dr Yadollah Zarei, Dr Mohamad Reza Hadavi, Dr Shojaolhagh Tarogh,
Volume 4, Issue 1 (1-2015)
Abstract
BACKGROUND
Rhinoplasty is one of the most common surgeries of the plastic surgery and as well as ear, throat and nose. Intra-operative bleeding during surgery is one of the most important factors that may impair the surgeon’s job. Providing a clean blood-free surgical filed makes the operation faster, easier and with a better quality. One way to achieve this goal is to induce hypotension. This study aimed to compare the impacts and outcomes of administration of labetalol or nitroglycerin for this purpose.
METHODS
In this randomized clinical trial, 60 ASA I and ASA II patients who were referred for rhinoplasty were enrolled. Patients were randomly assigned to two groups. Labetalol was given to the first and nitroglycerin to the second group of patients. Blood pressure and the amount of intra-operative bleeding during surgery and surgeon satisfaction were measured.
RESULTS
The average age of patients was 25.9±7.52 years. The average amount of bleeding among all patients was 117.87±324.86 ml, and the average quality of the surgical site was 1.65±4.48, considering all patients. The average quality and average surgical site bleeding between the two groups was not significant.
CONCLUSION
There was a little difference between labetalol and nitroglycerine on the effect of intraoperative blood loss and surgical field quality in rhinoplasty surgery.
Dr Ali Manafi, Dr Zahra Sadat Hamedi, Dr Amir Manafi, Dr Afsaneh Rajabiani, Dr Ahmadreza Rajaee, Dr Farzad Manafi,
Volume 4, Issue 2 (7-2015)
Abstract
BACKGROUND
Filler materials are gaining popularity in nonsurgical rhinoplasty the major advantages are the ability to camouflage the surface deformities, and also the soft and malleable consistency while the major drawback of the safe fillers such as hyaluronic acid is short durability. In this study, we evaluated the injectable cartilage shaving as an autologous filler material for correction of minor contour deformities in rhinoplasty.
METHODS
Injectable cartilage shaving was used for correction of surface irregularities in primary or secondary rhinoplasty, and long term results of 128 patients were evaluated. The source of cartilage was autologous septum, rib or less frequently, the ear concha. The material was injected with 14 to 18 gauge needles or blunted tip lipofilling cannulas with 1.3-1.7 mm internal diameters. It was performed whether during the septorhinoplasty or as a separate single procedure without elevation of the flap. Success was defined as the long term survival of the graft in the desired site and absence of recurrent deformity or complications such as extrusion, infection or displacement.
RESULTS
Twenty seven males and 101 females underwent the procedure from May 2008 to January 2014. Mean follow up period was 31 (13-58) months. Ninety five percent of patients were satisfied or very satisfied with the results at the last follow up visits and touch up procedure was performed for the unsatisfied patients.
CONCLUSION
Injectable cartilage shaving is a reliable filler to correct and camouflage the surface irregularities, and it is durable and predictable in long term follow ups.
Ali Ebrahimi, Mohammad Hosein Kalantar Motamedi, Amin Shams, Nasrin Nejadsarvari,
Volume 5, Issue 1 (1-2016)
Abstract
Mohammad Reza Farahvash, Ghasemali Khorasani, Yadallah Mahdiani, Ahmad Reza Taheri,
Volume 5, Issue 1 (1-2016)
Abstract
BACKGROUND
Early postoperative edema and ecchymosis are the most common factors to complicate initial patient perceptions about rhinoplasty. The current study was conducted to determine the effects of longer steri-strip tape on patient cheek in terms of ecchymosis control and reduction.
METHODS
Through a randomized controlled clinical trial, 70 patients who underwent rhinoplasty were randomly enrolled. One side of the patients’ face was randomly selected for different experience of dressing while the main intervention was different length of tape and steri-strip dressing. In one group, the right side and in the rest, the left side of face was applied with steri-stip tape over lower lid and from nose to lateral cheek and malar area at one side to the other side.
RESULTS
The mean area of ecchymosis after rhinoplasty through our trial was 1.55 mm and 2.31 mm, respectively in sides with and without steri-strip which differed significantly. When patients’ age and sex were taken into account, the distribution of ecchymosis had no significant difference in this regard.
CONCLUSION
The present study showed significant reduction in the area of post-rhinoplasty ecchymosis in lower lid, malar and cheek soft tissues as well as the obvious increase in satisfaction rate among intervention side of face in comparison to the control side. But longer steri-strip tape failed to control sub conjunctival bleeding or decrease it.
Ali Manafi, Farzad Manafi,
Volume 5, Issue 1 (1-2016)
Abstract
Seyed Esmail Hassanpour, Ataollah Heidari, Seyed Mehdi Moosavizadeh, Mohammad Reza Tarahomi, Ali Goljanian, Sanaz Tavakoli,
Volume 5, Issue 2 (4-2016)
Abstract
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. The functional and aesthetic outcomes were compared between the two techniques of spreader and autospreader graft using rhinomanometry and satisfaction questionnaire in two stages before and one months after the surgery.
RESULTS
Total nasal airway resistance increased significantly by both spreader and autospreader, but the difference between the two methods was not statistically significant. The total nasal flow before and after the surgery significantly decreased using both techniques, but this reduction was not significant between the two methods of surgery. When questioned about the satisfaction with the surgery outcomes, 18 subjects (36%) had complete aesthetic satisfaction, 25 (50%) were partial satisfied and 7 subjects (14%) were unsatisfied from aesthetic results. The rate of patient’s satisfaction in both groups was higher for functional outcome. Overall, 32 (64%) subjects were completely satisfied, 13 (26%) were partially satisfied and 5 (10%) subjects did not report satisfaction. Loss of respiratory function in both groups was inevitable due to short time post-operative period.
CONCLUSION
Both spreader graft and autospreader graft techniques can be used in the preservation and restoration of the normal internal nasal valve angle, as well as restoration of dorsal aesthetic lines of the nasal dorsum.
Arash Beiraghi-Toosi, Seyed Mohammad Motamedalshariati, Samira Ghanei, Rowshanak Afshar,
Volume 5, Issue 3 (7-2016)
Abstract
Sadrollah Motamed, Alireza Saberi, Feyzollah Niazi, Hojjat Molaei,
Volume 6, Issue 2 (4-2017)
Abstract
BACKGROUND
Osteotomy is one of the major steps in rhinoplasty. The aim of study was to compare edema and ecchymosis after external and internal lateral osteotomy in patients who underwent rhinoplasty.
METHODS
Based on a prospective randomized clinical trial, 168 osteotomies were performed through an external route in a perforating fashion and internal route in a continuous fashion at right or left side respectively in any patient. Subjective scoring system was applied to evaluate edema and ecchymosis on 1st, 3rd, 7th, and 30th days after surgery.
RESULTS
Edema and ecchymosis were the same in both types of osteotomies.
CONCLUSION
Regarding edema and ecchymosis, there was not any significant difference between external and internal osteotomies in rhinoplasty.
Ali Manafi, Ali Kaviani, Zahra Sadat Hamedi, Afsaneh Rajabiani, Navid Manafi,
Volume 6, Issue 2 (4-2017)
Abstract
BACKGROUND
There are numerous methods to mold and shape cartilage grafts for use in rhinoplasty. Each technique has advantages and disadvantages. We are going to introduce a new method for cartilage shaping with long lasting effects confirmed by follow up examination and pathologic evaluation.
METHODS
Grated cartilage was used in 483 patients. For 89 cases, it was wrapped in fascia and in 394 patients, used as a filler per se or in contiguity with solid structural grafts. In 51 patients, the operation was primary rhinoplasty and 432 cases, underwent secondary rhinoplasty. Postoperatively, there was a mean follow up of 2.8 years. Graft viability, and capability to maintain almost original volume, and general durability were assessed.
RESULTS
Out of 483 patients, only 23 cases (4.7%) needed later correction. In 11 cases (2%), it was due to overcorrection and some minor imperfections. In the rest 12 cases (2%), there was a need for more augmentation probably due to some degree of graft resorption. Three cases of these 12 patients, were corrected by outpatient shaved cartilage injection.
CONCLUSION
According to the very low revision rate (less than 5%), we strongly recommend our grated cartilage graft for use in primary and secondary rhinoplasty. Our study showed that patient and surgeon`s satisfaction can be achieved with a high degree of confidence.
Shirin Loghmani, Shahriar Loghmani, Hebatollah Baghi, Mohammad Ali Hoghoughi, Fariba Dalvi,
Volume 6, Issue 3 (7-2017)
Abstract
BACKGROUND
One of the most common cosmetic surgeries is rhinoplasty. Iran has the highest rate of rhinoplasty, worldwide. The aim of this study was to compare the demographic characteristics of patients’ undergone rhinoplasty during two-time-period with a 10-year-interval in a single surgical center in Isfahan, Iran.
METHODS
In a retrospective study, data of the patients who were scheduled for elective rhinoplasty including their age and gender in two-time-period (2005 and 2015) were collected and compared.
RESULTS
Data of the 470 and 472 patients’ undergone elective primary rhinoplasty during 2005 and 2015 were collected, respectively. In 2005, the age range of patients was 16-51 years. Frequency of patients aged less than 20 years and more than 40 years was 27.1% and 3%, respectively. In 2015, the age range of patients was 16-59 years. Frequency of patients aged less than 20 years and more than 40 years was 12.9% and 5.6%, respectively. Patients in the two studied periods were similar regarding gender, but the mean age of patients had a significant increase during the time.
CONCLUSION
Most of our patients were female and the female to male ratio was similar in two studied periods, but it seems that rhinoplasty request is higher in older age in recent years. It is recommended to plan a trend study and more studies considering other factors to be effective in epidemiologic feature of rhinoplasty in our community.
Fatih Ozdogan, Halil Erdem Ozel, Erkan Esen, Selahattin Genc, Adin Selcuk,
Volume 7, Issue 1 (1-2018)
Abstract
Ali Kavyani, Ali Manafi,
Volume 7, Issue 1 (1-2018)
Abstract
There are some rare but probable devastating complications following any rhinoplasty. Charlin’s syndrome is a typical one. It is completely related to the external nasal nerve. In this report, we are presenting a 21-year-old female with signs and symptoms of Charlin’s syndrome, persisting for 4 years after a routine septorhinoplasty operation. Surgery was uneventful and the patient underwent bony septal resection and caudal septal relocation. Osteotomy was internal low to low and external transverse bilaterally. Overall, a routine septorhinoplasty was executed. Everything went well postoperatively, until 4 months after surgery, when some irritating symptoms developed and gradually intensified.
Pauline Joy Santos, David A Daar, Keyianoosh Paydar, Garrett A Wirth,
Volume 7, Issue 1 (1-2018)
Abstract
BACKGROUND
Rhinoplasty is a popular aesthetic and reconstructive surgical procedure. However, little is known about the content and readability of online materials for patient education. The recommended grade level for educational materials is 7th to 8th grade according to the National Institutes of Health (NIH). This study aims to assess the readability of online patient resources for rhinoplasty.
METHODS
The largest public search engine, Google, was queried using the term “rhinoplasty” on February 26, 2016. Location filters were disabled and sponsored results excluded to avoid any inadvertent search bias. The 10 most popular websites were identified and all relevant, patient-directed information within one click from the original site was downloaded and saved as plain text. Readability was analyzed using five established analyses (Readability-score.com, Added Bytes, Ltd., Sussex, UK).
RESULTS
Analysis of ten websites demonstrates an average grade level of at least 12th grade. No material was at the recommended 7th to 8th grade reading level (Flesch-Kincaid, 11.1; Gunning-Fog, 14.1; Coleman-Liau, 14.5; SMOG 10.4; Automated Readability, 10.7; Average Grade Level, 12.2). Overall Flesch-Kincaid Reading Ease Index was 43.5, which is rated as “difficult.”
CONCLUSION
Online materials available for rhinoplasty exceed NIH-recommended reading levels, which may prevent appropriate decision-making in patients considering these types of surgery. Outcomes of this study identify that Plastic Surgeons should be cognizant of available online patient materials and make efforts to develop and provide more appropriate materials. Readability results can also contribute to marketing strategy and attracting a more widespread interest in the procedure.
