Intraoperative Measurement of the Anatomic Features of the Lower Lateral Cartilage and Nasal Tip Shape of the Asian Nose

Na, Hyung Gyun; Jang, Yong Ju

doi:10.1001/jamafacial.2018.0570

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…Ethnic considerations are well described in the rhinoplasty and facial plastic surgery literature. 14-21 In the FFS literature, Balaji 22 noted differences in the Indian and Western facial profiles and described “social-cultural ethos” relevant to Indian patients undergoing FFS. Additional dedicated investigations are needed to elucidate race and ethnic considerations in FFS.…”

Section: Discussionmentioning

confidence: 99%

“…Other possible hypotheses include discrepancies in health care access, selection bias, and any multitude of health factors influencing surgical candidacy. Ethnic considerations are well described in the rhinoplasty and facial plastic surgery literature 14–21 . In the FFS literature, Balaji 22 noted differences in the Indian and Western facial profiles and described “social‐cultural ethos” relevant to Indian patients undergoing FFS.…”

Section: Discussionmentioning

confidence: 99%

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Initial Facial Feminization Surgery Experience in a Multicenter Integrated Health Care System

Chou

Tejani

Kleinberger

et al. 2020

Otolaryngol.--head neck surg.

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Objective There are few large studies on facial feminization surgery (FFS). We provide the largest comprehensive report to date of an FFS cohort regarding the safety of multilevel surgery, patient-specific considerations with FFS procedures, and complications of surgery. Study Design Retrospective cohort study. Setting Multicenter integrated health care system. Subjects and Methods We examined all patients undergoing FFS within our institution from April 2016 to October 2018. Patients over the age of 18 with a diagnosis of gender dysphoria underwent any combination of scalp advancement, cranioplasty, brow lift, rhinoplasty, upper lip lift, mandibuloplasty, chondrolaryngoplasty, and/or additional cosmetic procedures. Medical records were reviewed for preoperative characteristics, FFS procedures undergone, and postoperative complications. Results In total, 121 patients underwent a total of 594 FFS procedures. Seventy-five percent of patients had only 1 or no comorbidities, and 90% of patients underwent cranioplasty, scalp advancement, and brow lift. African American patients (n = 5) less commonly underwent cranioplasty compared to those of other ethnicities (white, P < .001; Asian, P = .022; Hispanic, P = .014; multiracial, P = .006). Asian patients less commonly underwent rhinoplasty than white patients (38% vs 73%, P = .023). Only 8 (6.6%) patients experienced a significant complication after surgery. Conclusions The population undergoing FFS is generally healthy, the upper third of the face is most commonly addressed, there are age and ethnic considerations in FFS, and major complications after multilevel surgery are uncommon.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Initial Facial Feminization Surgery Experience in a Multicenter Integrated Health Care System

Chou

Tejani

Kleinberger

et al. 2020

Otolaryngol.--head neck surg.

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“…20 In a study on Asian ethnicity, 89% of patients undergoing rhinoplasty showed LCCM, yet many of them did not show any tip deformities. 21 In another study on 60 patients in Brazil, 38% had LCCM. 5 The frequency of cephalic malposition in our study was lower than the percentage reported in previous studies (31.3%), which could be due to a larger patient population and Caucasian ethnicity.…”

Section: Discussionmentioning

confidence: 95%

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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“… 8 Cephalic malposition affects external features, such as nasal tip shape and alar rim, as well as the nasal obstruction results. 9 Various maneuvers are considered specifically to correct this abnormality, such as composite grafts, and repositioning, or even cartilage Z-plasty. 10 Therefore, it is necessary to know the normal range of LCDA to obtain the best aesthetic results.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Lateral Crura Divergence Angle of Iranian Candidates for Primary Rhinoplasty

Loghmani¹,

Loghmani²,

Irani

et al. 2021

wjps

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BACKGROUND Cephalic malposition of the lower lateral cartilages is a common nasal anatomic variation. Knowing the range of lateral crura (LC) divergence angle in Iranian population can help Middle East plastic surgeons. This study aimed to determine LC divergence angle of candidates for primary rhinoplasty in Iranian population. METHODS This cross-sectional study was conducted on 256 candidates for primary rhinoplasty from November 2017 through May 2018. Two sides of LC divergence angle were measured intraoperatively by a researcher-made device. RESULTS Totally, 211 female and 45 male patients with the mean age of 29.9±6.51 years were recruited. The mean LC divergence angle was 35.86±4.74° (between 20-50°). The mean LC divergence angle was 35.11° and 36.02° in male and females, respectively. There was no significant difference between males and females. In addition, there was no significant correlation between LC divergence angle and age. LC divergence angle had normal distribution and about 68% of the LC divergence angle were within one standard deviation of the mean (i.e. 32 to 40 degree). CONCLUSION In 16% of studied people, the divergence angle of the lateral crus of the lower lateral cartilage was lower than 32° and was considered as malposition.

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Intraoperative Measurement of the Anatomic Features of the Lower Lateral Cartilage and Nasal Tip Shape of the Asian Nose

Cited by 4 publications

References 6 publications

Initial Facial Feminization Surgery Experience in a Multicenter Integrated Health Care System

Initial Facial Feminization Surgery Experience in a Multicenter Integrated Health Care System

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

Evaluation of Lateral Crura Divergence Angle of Iranian Candidates for Primary Rhinoplasty

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