Correction of Nasal Pinching

Hyman, Ari J.; Khayat, Sarah; Toriumi, Dean M.

doi:10.1016/j.fsc.2019.07.004

Cited by 15 publications

(6 citation statements)

References 10 publications

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“…6 25 26 27 28 Meanwhile, the main and most effective techniques remain the classic repositioning and alar grafts. 29 30 31 32 The proper use of repositioning and alar grafting can bring the desired shadowing of nasal tip. 7 Selection of the best correction method for each patient must be based on the patient's needs; it should provide stability as well as best surface aesthetics for each patient.…”

Section: Discussionmentioning

confidence: 99%

Inaccuracy of Standard 2D Photography for the Diagnosis of Cephalic Malposition of Lateral Crural Cartilages

2021

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Lateral crural cephalic malposition (LCCM) is a well-known deformity of the nasal tip which contributes to functional disturbances of the external nasal valve. Accurate diagnosis of this deformity helps surgeons plan for better outcomes. A total of 176 candidate patients for primary rhinoplasty underwent standard 2D medical photography of the face. Senior authors analyzed photography results and differentiated the patients with LCCM. In addition, we measured the angle between the dorsal septum and lateral end of the long axis of the alar cartilage in the operation room. Ninety-five patients were diagnosed with LCCM on photography. As much as 31.3% (55) of all the patients had LCCM in intraoperative measurements. The sensitivity and specificity of 2D photography for diagnosing LCCM were 0.7924 and 0.5391, respectively. The main surgical techniques for correction of LCCM were alar repositioning (34.3% in total, 56% in LCCM patients) and lateral crural strut graft (43.8% in total, 69% in LCCM patients). LCCM is overdiagnosed via 2D photography, and this method lacks sensitivity. The overall frequency of LCCM seems to be lower than the previously reported frequency. For optimal results in rhinoplasty, surgeons must focus on the best contouring and function rather than solely correcting angles and rotations.

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Section: Discussionmentioning

confidence: 99%

Inaccuracy of Standard 2D Photography for the Diagnosis of Cephalic Malposition of Lateral Crural Cartilages

2021

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“…If the upper lateral cartilage is too narrow, a spreader graft or a flaring suture can be considered [2,3]; if the scroll area is weakened, the alar batten graft would be a good treatment [1,4,5]. If there is a problem with the anatomy or supporting structure of the lower lateral cartilage, it is possible to consider lateral crural reshaping, such as the lower lateral crural turnover flap, alar contour graft, cephalic trimming of the lateral crura, and additional alar batten graft or lateral crural strut graft [6][7][8][9]. If there is a contracted scar on the nasal valve, it is difficult to correct nasal valve collapse, and scars can be corrected with Z-plasty [1].…”

Section: Wwwjcosmetmedorgmentioning

confidence: 99%

The functional and cosmetic aspects of alar batten graft

Hong

Choi

2022

J Cosmet Med

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Nasal valve collapse due to lateral nasal wall incompetence hinders the quality of life of patients. It can also cause cosmetic problems, leading patients to seek surgical treatment. Nasal valve collapse is caused by an interruption of the systematic relationships between the septal cartilage, inferior turbinate, and upper and lower lateral cartilage. In particular, when solving problems with the upper and lower later cartilage, the alar batten graft is considered an important surgical method. Herein, we present an example of patients with lateral nasal wall incompetence and the detailed surgical method of the applied alar batten graft to solve this problem. There were no significant adverse effects, and the operator and the patients were satisfied with the functional and cosmetic results.

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“…When this is not the case, lateral compartment support can also be achieved by the placement of alar rim grafts. 30 These grafts can typically achieve 1 to 2 mm of inferior displacement of the ala. 14 To place the rim graft, the alar margin is first injected with 1% lidocaine mixed with 1:100,000 epinephrine with the intention to hydrodissect the tissue plane. A wide double prong skin hook is used to expose the rim margin.…”

Section: Alar Rim Graftmentioning

confidence: 99%

“…The grafts which are usually fashioned from septal or conchal cartilage are often 2 to 3 mm wide and 12 to 25 mm long. 29,30 The edges of the rim grafts should be beveled or gently morselized to reduce their visibility and palpability. The graft is inserted into the created packet and the incision is then closed with 5-0 fast absorbing suture (Ethicon).…”

Section: Alar Rim Graftmentioning

confidence: 99%

“…These techniques can contribute to an unnatural appearing nose in which the tip is asymmetric, overly narrow, isolated from the surrounding nasal subunits, and lacks appropriate support. 30 As healing progresses nasal valve compromise can occur from excessive tip narrowing and disruption of the structural integrity of the tip complex. Not infrequently used grafts may become malpositioned, warped, or infected contributing to aesthetic and functional dissatisfaction.…”

Section: Complications Of Tip Rhinoplastymentioning

confidence: 99%

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Narrowing the Wide Tip via Endonasal Approach

Sulyman

Dayan

2021

Facial Plast Surg

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Rhinoplasty is arguably the most complex and intricate surgery performed by facial plastic surgeons. Nasal tip refinement of a broad nasal tip has remained the most challenging part of rhinoplasty as sophisticated techniques are critical to achieve aesthetically pleasing and structurally sound nasal tips that can withstand the contractile forces of healing. Successful tip refinement relies on an in-depth preoperative and intraoperative understanding of the patient's nasal anatomy, well developed arsenal of techniques, the experience of the surgeon, and the aesthetic desires of the patient. Although the approach to gain access to the nasal tip so as to successfully reshape the tip has been a topic of debate over many years, the aim of this article is to outline and demonstrate how the broad nasal tip can be successfully recontoured through an endonasal approach using nondestructive techniques that have been effectively used in open rhinoplasty. We believe that there continues to be a place for endonasal tip rhinoplasty especially in this era in which patients desire less invasive procedures with shorter healing time.

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Correction of Nasal Pinching

Cited by 15 publications

References 10 publications

Inaccuracy of Standard 2D Photography for the Diagnosis of Cephalic Malposition of Lateral Crural Cartilages

Inaccuracy of Standard 2D Photography for the Diagnosis of Cephalic Malposition of Lateral Crural Cartilages

The functional and cosmetic aspects of alar batten graft

Narrowing the Wide Tip via Endonasal Approach

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