Cosmetic Rhinoplasty

Abstract

Learning Objectives: After studying this article, the participant should be able to: 1. Perform a systematic nasofacial analysis. 2. Identify the underlying anatomical cause of specific external nasal findings. 3. Recognize the interrelated effects of operative maneuvers. 4. Develop an appropriate operative plan to address patient concerns. Summary: The rhinoplasty operation is one of the most challenging procedures in plastic surgery, and requires a combination of surgical judgment, knowledge of anatomy, technical skill, and lifelong study. A foundation must be built on clearly defined patient goals and an accurate diagnosis, based on known ideals and their anatomical correlation. It is important to recognize the definitive impact of each operative maneuver to achieve predictable outcomes. This article provides a problem-based approach to common cosmetic nasal deformities.

Optimizing precision rhinoplasty: comprehensive preoperative planning with nasal computed tomography for functional and aesthetic enhancement

“…The following anatomical details of the external nose and nasal cavity were accessible through computed tomography (CT) imaging, influencing preoperative planning and subsequent surgical maneuvers: nasal septum (detection of septal deviations, spurs, and deviations in the septal cartilage; identification of septal thickness variations), turbinates (visualization of turbinate hypertrophy and anatomical variations; assessment of the size, shape, and configuration of the inferior and middle turbinates), nasal dorsum (detailed imaging of the nasal dorsum, including bony and cartilaginous components; identification of dorsal humps, depressions, and deviations), nasal tip (visualization of the nasal tip structure, including the alar cartilages, assessment of tip projection, rotation, and symmetry), nasal bones (detailed imaging of the nasal bones, aiding in the assessment of fractures or deviations), nasal alae (detection of asymmetry or irregularities in the nasal alae; visualization of the nasal alar contour), soft tissues and skin (assessment of skin thickness and soft tissue characteristics, which can impact surgical planning, especially in rhinoplasty), paranasal sinuses (evaluation of paranasal sinuses — such as the maxillary, ethmoid, frontal, and sphenoid sinuses — for potential anatomical variations or pathology), nasopharynx (visualization of the nasopharynx, which may influence surgical decisions related to airflow and function), and olfactory structures (though not always the primary focus, CT may provide information on the olfactory structures within the nasal cavity) (Table 1 ) [ 14 – 16 ].…”