Role of the Cephalic Trim in Modern Rhinoplasty

Nagarkar, Purushottam; Stark, Ran Y.; Pezeshk, Ronnie A.; Amirlak, Bardia; Rohrich, Rod J.

doi:10.1097/prs.0000000000001860

Cited by 27 publications

(15 citation statements)

References 13 publications

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“…19 The second is the tendency toward conserving and augmenting the skeletal framework rather than resecting it. [20][21][22][23][24][25][26] Though more conservative techniques for tip plasty are evolving, 27 less conservative techniques as incising, scoring, and particularly resecting portions of the lower lateral cartilage (LLC) are still heavily adopted. 3,9,28 Resection exceeding the tip structural stability threshold results in distortion and collapse of the tip framework, unless structural support is properly restored.…”

Section: Discussionmentioning

confidence: 99%

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The miniature lateral crural strut graft: Efficacy of a novel technique in tip plasty

Abdelwahab

Most

2020

The Laryngoscope

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Objectives/Hypothesis: To describe a novel technique for tip plasty and determine its efficacy using validated patientreported outcome measures and objective measures. Study Design: Retrospective cohort study. Methods: This study was carried out at a tertiary center. Patients undergoing tip plasty using the miniature lateral crural strut grafts (mini-LCSG) in cosmetic/combined rhinoplasty between January 2016 and August 2019 with available outcome measures were included. We used the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS), Nasal Obstruction Symptom Evaluation (NOSE) scores, visual analog scale: functional and cosmetic, and lateral wall insufficiency (LWI) grades. Results: Among 52 patients, 33 were included; 26 had cosmetic whereas seven had combined functional and cosmetic rhinoplasty, with a follow-up up to 3 years. Both cosmetic and combined subjects showed significant improvement in SCHNOS-Cosmesis (C) scores (−57.31

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Section: Discussionmentioning

confidence: 99%

“…The first is the increased demand of evidence‐based medicine with particular emphasis on validated PROMs, because the primary goal is the patient's satisfaction . The second is the tendency toward conserving and augmenting the skeletal framework rather than resecting it …”

Section: Discussionmentioning

confidence: 99%

The miniature lateral crural strut graft: Efficacy of a novel technique in tip plasty

Abdelwahab

Most

2020

The Laryngoscope

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“…Medial, transverse, and lateral osteotomies were performed in 95% of the patients. Tip remodeling was obtained by using several techniques such as cephalic alar cartilage resection and repositioning 16 (50% of cases), dome division 17 (3 cases), lateral crural steal 18 (7 cases), and grafts positioning (60% of cases, including columellar strut, shield graft, cap grafts, alar batten graft) to provide for an adequate framework if needed.…”

Section: Surgical Techniquementioning

confidence: 99%

The Rhino-Lip-Lifting: A Novel Proposal for Midface Profileplasty Performed as a Single Surgical Procedure

Pascali

Marchese²,

Diaspro³

2021

Facial Plast Surg

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As facial aging occurs, aesthetic changes of the nasal tip and the senile upper lip include tip ptosis, increase in skin length, loss of vermillion height and Cupid's bow, and vertical wrinkles.Regardless of the rejuvenation procedure, the lips are not to be considered as a single anatomical entity, instead they should be placed in a strong correlation with the nose. The aim of this study is therefore to demonstrate the effectiveness of the association of primary closed rhinoplasty together with indirect subnasal lip-lifting technique.A total of 45 patients were enrolled in this study and underwent primary closed rhinoplasty with indirect subnasal lip-lifting. The result showed an overall average nasolabial angle width reduction of 10.9% and lip length shortening of 23.5%, as assessed 1 year after the surgical procedure. When comparing before and after photographs and using the Subjective Global Aesthetic Improvement Scale (sGAIS), the overall satisfaction was rated 4.4 on 5, as “much improved.”The authors show that lips should not be considered as a single anatomical entity but that they indeed must be placed in a strong correlation with the nose since a droopy nasal tip is likely to be considered unattractive and is often associated with the appearance of a long nose with covered philtrum and upper lip.Tip rotation to a normal nasolabial angle width could grant a beneficial impact on overall nose aesthetics; however, it may not fully balance the midface profile as it is the “lip position-to-incisal show” ratio that defines beauty, whereas the balance among forehead, nasal tip, upper lip, and chin is what defines the contour of harmonious profiles.This is the first patient series to show that the combination of closed rhinoplasty and indirect lip-lifting is a highly effective, safe, and reliable procedure to address profile rejuvenation.

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“…Cephalic trimming, which was also performed in all cases, aids in tip definition and rotation but can injure the underlying mucosa, deforming the tip with aggressive resection, or affecting an originally weak external valve function, as in most Middle-Eastern noses. 9 …”

Section: Casesmentioning

confidence: 99%

Rotating the Tip in Long Noses: A Strategy rather than a Single Technique

Abdelkader

El-Noamany

Makarem

2021

Plastic and Reconstructive Surgery - Global Open

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Background: Rhinoplasty is one of the most commonly performed aesthetic surgical procedures in plastic surgery, the incidence of which has increased up to approximately 1 million cases in 2016 according to the recent International Society of Aesthetic Plastic Surgery survey. This study aimed at defining the importance of each sequential procedure within the same surgery, the extent to which a procedure can be performed, and those that can be omitted. Methods: In this descriptive study, 27 candidates (18 women; nine men; age range, 20–48 years) for primary rhinoplasty between September 2016 and September 2019 were included. All had long noses, their main concern was reduction of nasal tip projection and all were seeking cranial tip rotation to enhance their tip aesthetics. Those who required revision rhinoplasty or who had nasal deformities due to congenital defects, and those older than 60 or younger than 18 years of age, were excluded. Results: The average nasolabial angle in women preoperatively was 88.2 ± 6.6 and postoperatively 102.8 ± 5.6. In men, the average average nasolabial angle preoperatively was 79.6 ± 5.4 and postoperatively 92.3 ± 2.3. In both men and women, the P value was <0.001, which indicates high significance. Tip rotation was achieved in all patients, with 81% achieving ideal rotation, and 19% exceeding the ideal range. Conclusions: Rotating the tip in long noses is a complex procedure. It can be achieved by many described techniques, but not all are required. A general strategy should be followed during which variable techniques, with varying efficacy, can be utilized.

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Role of the Cephalic Trim in Modern Rhinoplasty

Cited by 27 publications

References 13 publications

The miniature lateral crural strut graft: Efficacy of a novel technique in tip plasty

The miniature lateral crural strut graft: Efficacy of a novel technique in tip plasty

The Rhino-Lip-Lifting: A Novel Proposal for Midface Profileplasty Performed as a Single Surgical Procedure

Rotating the Tip in Long Noses: A Strategy rather than a Single Technique

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