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Bony Dorsal Preservation.
Rhinoplasty is undergoing a transformation with the reemergence of dorsal preservation rhinoplasty (DPR) techniques. This article introduces a novel addition to the DPR repertoire, "bony dorsal preservation" (BDP), which has particular appl…
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Skin Contour Sutures in Rhinoplasty.
[BACKGROUND] The skin-soft tissue envelope (STE) is a critical component of rhinoplasty and can have a significant impact on the final result. Skin contour sutures (SCSs) can be used to prevent potential complications related to skin detach…
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A 3-Level Impaction Technique for Dorsal Reshaping and Reduction Without Dorsal Soft Tissue Envelope Dissection.
[BACKGROUND] Preservation rhinoplasty (PR) techniques are continuously evolving and many variations of established techniques have been proposed since Daniel coined this term in 2018. [OBJECTIVES] The aim of this study was to describe indi…
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Composite Dorsal Augmentation.
[BACKGROUND] Dorsal augmentation is one of the most challenging procedures in rhinoplasty. Solid grafts and diced fascia graft (DC-F) have been employed for this purpose with varying success. Warping, irregularities, and variability of fina…
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Cone-Beam Computed Tomography: A User-Friendly, Practical Roadmap to the Planning and Execution of Every Rhinoplasty-A 5-Year Review.
[BACKGROUND] Cone-beam computed tomography has recently rapidly developed worldwide as a versatile and convenient alternative to traditional computed tomography for imaging of the maxillofacial region. However, most surgeons performing rhin…
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Rhinoplasty: Aesthetic Augmentation With Improvement of Dorsal Aesthetic Lines.
[BACKGROUND] Camouflage of nasal dorsum, aesthetic augmentation, and highlighting the dorsal aesthetic lines are essential elements in modern rhinoplasty. Numerous techniques have been utilized, including deep temporal fascia, rectus abdomi…
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Decision Making in Preservation Rhinoplasty: A 100 Case Series With One-Year Follow-Up.
[BACKGROUND] Preservation rhinoplasty (PR) is a new chapter in rhinoplasty history. The term was coined by Daniel in 2018 and represents a fundamental change in philosophy. [OBJECTIVES] The aim of this study is to discuss a single-surgeon …
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Current Trends in Preservation Rhinoplasty.
Recently there has been a dramatic acceptance of the preservation principle in rhinoplasty surgery. Surgeons worldwide now preform preservation rhinoplasty, which has led to an expanding list of indications and techniques. Most rhinoplasty …
- Commentary on: Dorsal Roof Technique for Dorsum Preservation in Rhinoplasty.
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Rhinoplasty: A Sequential Approach to Managing the Bony Vault.
[BACKGROUND] An important element of most rhinoplasty surgeries is the treatment of the nasal bones, which involves various combinations of osteotomies and hump removal. [OBJECTIVES] The aim of this paper was to describe a rhinoplasty tech…
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Dorsal Preservation: The Push Down Technique Reassessed.
Management of the nasal dorsum remains a challenge in rhinoplasty surgery. Currently, the majority of reduction rhinoplasties results in destruction of the keystone area (K-area), which requires reconstruction with either spreader grafts or…
- The Preservation Rhinoplasty: A New Rhinoplasty Revolution.
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The Nasal Ligaments and Tip Support in Rhinoplasty: An Anatomical Study.
[BACKGROUND] In 1971, Janeke and Wright1 published a now classic study on the support of the nasal tip in which they found four areas of anatomic support. These findings led to the "tripod concept" of tip support. Recently, surgeons have be…
- Reassessing Surgical Management of the Bony Vault in Rhinoplasty.
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Asian Cleft Rhinoplasty: The Open Structural Approach.
[BACKGROUND] Asian cleft rhinoplasty is a unique procedure with specific challenges. [OBJECTIVES] This paper presents our experience with the use of an open structural technique for Asian cleft rhinoplasty utilizing a complete autologous a…
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The Role of Piezoelectric Instrumentation in Rhinoplasty Surgery.
[BACKGROUND] In rhinoplasty surgery, management of the bony vault and lateral walls is most often performed with mechanical instruments: saws, chisels, osteotomes, and rasps. Over the years, these instruments have been refined to minimize d…
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Surface Aesthetics and Analysis.
Surface aesthetics of an attractive nose result from certain lines, shadows, and highlights with specific proportions and breakpoints. Analysis emphasizes geometric polygons as aesthetic subunits. Evaluation of the complete nasal surface ae…
- Response to "Comments on 'The Role of Piezoelectric Instrumentation in Rhinoplasty Surgery'".
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Rhinoplasty: The Asymmetric Crooked Nose-An Overview.
There are three reasons why the asymmetric crooked nose is one of the greatest challenges in rhinoplasty surgery. First, the complexity of the problem is not appreciated by the patient nor understood by the surgeon. Patients often see the o…
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Superior rhinoplasty outcomes with precise nasal osteotomy: an individualized approach for maintaining function and achieving aesthetic goals.
[BACKGROUND] Although frequently performed in rhinoplasty, nasal osteotomies have been unpredictable in consistently controlling postoperative alterations in bony morphology in many patients. Consequently, a detailed algorithm for an indivi…
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The osseocartilaginous vault of the nose: anatomy and surgical observations.
[BACKGROUND] The dorsal hump and dorsal aesthetic lines have been considered bony and cartilaginous structures. Knowledge of the anatomy of the osseocartilaginous vault is essential for obtaining aesthetically pleasing results of rhinoplast…
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Rhinoplasty: the nasal bones - anatomy and analysis.
[BACKGROUND] The analysis of nasal anatomy, and especially the nasal bones including the osseocartilaginous vault, is significant for functional and aesthetic reasons. [OBJECTIVES] The objective was to understand the anatomy of the nasal b…
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The plunging tip: analysis and surgical treatment.
[BACKGROUND] The plunging tip refers to a deformity in which the nasal tip plunges on smiling. [OBJECTIVES] To understand the plunging tip, we have updated our series of 25 cosmetic rhinoplasty patients who complained of a plunging tip wit…
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The plunging tip: illusion and reality.
[BACKGROUND] The plunging tip is defined as a nasal deformity where the nasal tip descends or "plunges" during smiling. [OBJECTIVE] The authors prospectively measure a series of 25 patients with a focus on the anatomic changes of the nose …
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Rhinoplasty: the lateral crura-alar ring.
[BACKGROUND] Rhinoplasty surgeons routinely excise or incise the lateral crura despite nostril rim retraction, bossa, and collapse. Given recent emphasis on preserving the lateral crura, a review of the lateral crura's anatomy is warranted.…
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Reconstructive rhinoplasty: operative revision of patients with previous autologous costal cartilage grafts.
[BACKGROUND] Costal cartilage grafts are used more frequently in secondary rhinoplasty. However, these procedures result in patients that require further revision operations that are not trivial. The purpose of this study was to assess the …
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Surface Aesthetics in Tip Rhinoplasty: A Step-by-Step Guide.
Tip rhinoplasty is a key component of aesthetic rhinoplasty. An understanding of the correlation between tip surface aesthetics and the underlying anatomic structures enables proper identification and correction of tip abnormalities. Surfac…
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Rhinoplasty and brow modification: a powerful combination.
[BACKGROUND] Plastic surgeons have long recognized the importance of performing chin augmentation concurrent with a rhinoplasty to achieve facial balance. However, few surgeons consider the benefits of combining a rhinoplasty with brow modi…
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Endoscopic forehead lift. Aesthetics and analysis.
The endoscope already has revolutionized aesthetic forehead surgery by reducing the morbidity rate associated with the forehead lift operation. The ability to do the operation through a minimally invasive approach is predicated on the illum…
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The "biplanar" forehead lift.
A new technique of forehead rhytidectomy is presented that combines the best features of the coronal incision with those of the anterior hairline incision. The plane of dissection is formed by an anterior subcutaneous plane dissecting a lat…