Surgical Management of the Thick-Skinned Nose

Davis, Richard E.; Hrisomalos, Emily N.

doi:10.1055/s-0037-1617421

Cited by 25 publications

(36 citation statements)

References 9 publications

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“…The nasal SSTE consists of several layers: epidermis, dermis, subcutaneous fat (subcutis), the underlying superficial muscular aponeurotic system (SMAS), a variable deep fat layer, especially between the nasal domes, the muscular layer, and finally, the periosteum or perichondrium. Underneath the SSTE lies the nasal OCF 3,6,7 . The OCF is the main structure surgically manipulated during the rhinoplasty to achieve the anticipated nasal shape and function 3,6,8 .…”

Section: Essentials In Rhinoplastymentioning

confidence: 99%

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Dermatological assessment of thick‐skinned patients before rhinoplasty—what may surgeons ask for?

et al. 2022

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Rhinoplasty is considered a very challenging surgery since minimal changes of this central area of the face may significantly impact a person's appearance and self‐awareness. This is even more challenging in thick‐skinned patients because results are less predictable, and changes to the osseocartilaginous framework (OCF) may not be sufficiently visible due to the blanket effect of the thick skin. Furthermore, pre‐existing skin conditions may exacerbate following surgery. Therefore, managing patients with extremely thick skin or patients who suffer from pre‐existing dermatological conditions such as rosacea or acne requires a synergy of surgeons and dermatologists to achieve optimal results. In this article, we review the most significant pre‐ and post‐surgical regimens that surgeons and dermatologists should apply in selected patients to achieve optimal results after rhinoplasty.

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Section: Essentials In Rhinoplastymentioning

confidence: 99%

“…The surgeon may apply certain surgical maneuvers such as thinning out or thickening of the SSTE to enhance the cosmetic outcome. However, these sometimes tend to be solitarily insufficient 1,3,6,8,9 . Furthermore, pre‐existing skin conditions like acne, rosacea, or eczematous disorders may exacerbate perioperatively.…”

Section: Essentials In Rhinoplastymentioning

confidence: 99%

Dermatological assessment of thick‐skinned patients before rhinoplasty—what may surgeons ask for?

et al. 2022

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“…Moreover, it is usually less vascularized, making the perfusion to support retention of other structural grafts such as cartilage or fascia more difficult. 28,[33][34][35] The regenerative effect of the fat grafts on the surrounding tissues makes it an ideal graft to improve the quality and soften the scarred SSTE. 61,[63][64][65][66] The regenerative effect of fat grafting is well established in the scar and chronic wound therapy of various soft tissues.…”

Section: Using the Fat Grafting For Its Regenerative Potentialmentioning

confidence: 99%

“…The scarring of the nasal SSTE is known as the "shrinkwrap contracture phenomenon," and it can happen even years after the primary surgery. 28,[33][34][35] This deformational scar formation is prevalent in revision cases. The resultant change in nasal shape is a major reason structural avascular cartilaginous grafts are more likely to be used in secondary rhinoplasty.…”

Section: Introductionmentioning

confidence: 99%

The Role of Autologous Fat Grafting in Rhinoplasty

2022

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Rhinoplasty is one of the most popular aesthetic surgeries worldwide and often includes grafting techniques to achieve optimal results. One of these grafting techniques is autologous fat transfer, which has been used to increase volume, camouflage irregularities, and/or improve the quality of the nasal skin soft tissue envelope. Moreover, minimally-invasive approaches for altering the nasal appearance have recently increased and become known as "liquid" or "non-surgical rhinoplasty." These non-surgical approaches include altering the nasal appearance with filler injection to induce volumetric changes in lieu of extensive surgery. The use of fat grafting as a filler is favorable to achieve well-balanced aesthetic results without compromising the nasal skin soft tissue envelope. This capability is partly because of the regenerative potential of fat grafts, serving to improve the quality of surrounding soft tissues. In contrast, commercial injectable fillers are inert. This article highlights the role of fat grafting in surgical and non-surgical rhinoplasty to provide surgeons with an overview of the potential of these vastly abundant, biocompatible, and cost-effective grafts.

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“…The increased volume of ultrathick nasal skin and its susceptibility to edema further compound its inability to contract, thus inhibiting it from properly adhering to a surgically downsized nasal framework. 8 Rhinoplasty is a surgical procedure of which technique depends on the anatomy of the nose to be operated upon. The technique varies according to the possible anatomic variations, making it the most challenging of the cosmetic surgeries .…”

Section: Introductionmentioning

confidence: 99%

Volumeplasty of bulky nose using heat dermabrasion as a minor therapy

Sharquie¹,

Al-Jaralla²

2020

AJODRR

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Research Article AJODRR (2020) 3:18 Volumeplasty of bulky nose using heat dermabrasion as a minor therapy Background: Ultrathick nasal skin and nodulation is one of the most daunting challenges in cosmetic nasal surgery. Rhinoplasty is a common surgical procedure to correct mostly gross abnormal nasal anatomical variation; however, many patients have minor bizarre shape or deformities that could not be well corrected by ordinary surgical procedures. So we should find other techniques to correct these unwanted or undesired nose shape abnormalities. Objective: The purpose of this article is to perform heat dermabrasion to reduce the size of bulky nose and to create new alar groove and to remove nose nodulations, acne or traumatic scarring. Patients and methods: In this study, we collected 40 patients with bulky nose during the period from 2009 through 2019; 21 females and 19 males and their ages ranged from 20-65 years. An Informed consent was taken from each patient before starting the study, after full explanation about the procedure. All patients had bulky nose, some had nodulation of nose and acne or traumatic scarring. Only one patient had history rhinophyma of several years duration. All patients were treated with heat dermabrasion using diathermy needle after local xylocaine anesthesia and patients were received topical antiseptic and oral antibiotics to be seen after 2 weeks. Then topical corticosteroid was used to prevent post-inflammatory pigmentation.Results:A total of 40 patients diagnosed with bulky nose were enrolled in this study; 21 (52.5%) patients were females and 19 (47.5%) were males. Age of patients ranged from 20-65 years with a mean of 42.5 years. The duration of the condition ranged from few months to several years. In all patients with bulky nose were improved and alar groove were created or maximized and gave satisfactory cosmetic results using heat dermabrasion. Post-inflammatory hyperpigmentation was noticed but overtime was gone. Conclusion: heat dermabrasion using diathermy is new simple innovative minor technique to reduce size of bulky nose or small cosmetic abnormalities that could not be corrected by the standard classical rhinoplasty.This were carried under local anesthesia, need one session with minimal down time, without complications. Compared to dermabrasion by diathermy, CO2 dermabrasion is costy and usually needs many sessions, in addition to the undue laser exposure.

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Surgical Management of the Thick-Skinned Nose

Cited by 25 publications

References 9 publications

Dermatological assessment of thick‐skinned patients before rhinoplasty—what may surgeons ask for?

Dermatological assessment of thick‐skinned patients before rhinoplasty—what may surgeons ask for?

The Role of Autologous Fat Grafting in Rhinoplasty

Volumeplasty of bulky nose using heat dermabrasion as a minor therapy

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