Basic Principles of Closed Rhinoplasty Clinical Study of 20 years
Lampros ZOULOUMIS, Ioannis AETOPOULOS, Ioannis TILAVERIDIS, Maria LAZARIDOU, Grigoris VENETIS, Nikolaos LAZARIDIS
Department of Oral and Maxillofacial Surgery, Dental School, Aristotle University of Thessaloniki, ‘G. Papanikolaou’ General Hospital of Thessaloniki, (Head: Professor K. Antoniadis)
Hellenic Archives of Oral & Maxillofacial Surgery (2017) 2, 47-56
SUMMARY: The form and shape of the nose is an es- sential component of facial aesthetics, affecting indirectly the mental state and the personality development of the patient. The restoration of shape deformities and func- tional disorders are corrected by surgical procedures of open and closed rhinoplasty.
We present the basic principles of the closed rhinoplasty and our experience in restoring nasal deformities as nasal hump, with the method of closed rhinoplasty. Twenty patients underwent rhinoplasty from 1993 to 2013 using the closed method. Preoperative photographs were taken and a computer-simulated procedure was used to predict the outcome of rhinoplasty.
The results were satisfactory both immediately after surgery and at a later time. The evaluation was done both by the patients themselves and by the surgeon.
The closed rhinoplasty is a surgical technique with fewer complications as postoperative swelling, and better aes- thetics because of the absence of external scar. The access provided to the osteochondral skeleton of the nose, although it is limited, when proper preoperative evaluation is done, in the hands of surgeons with appropriate experience and expertise, can be the method of choice to repair deformities of the nose.
KEY WORDS: closed rhinoplasty, nasal hump, approach, nasal bones, outcome evaluation
REFERENCES
Abbou R, Bruant-Rodier C, Wilk A, Meningaud JP, Khan JL, Bosc R, Bodin F: Open rhinoplasty: influence of incisions, alar resection, and columellar strut on final appearance of the tip. Aesthetic Plast Surg 38(6):1077-82, 2014
Adelson R, DeFatta R, Bassischis B: Objective assessment of the accu- racy of computer-simulated imaging in rhinoplasty. American Jour- nal of Otolaryngology 29(3):151-155, 2008
Αηδόνης Α: Χειρουργική του ρινικού διαφράγματος και ρινοπλαστική. Εκδόσεις ‘Μαίανδρος΄, Θεσσαλονίκη , 1993, σελ. 74 -80.
Baker SR: Suture contouring of the nasal tip. Arch Facial Plast Surg 2(1):34-42, 2000
Bowles PF, Fu B, Cartwright SJ, Watts SJ: An alternative approach to primary rhinoplasty using Walsham forceps. J Laryngol Otol 128(11):1003-4, 2014
Caloss R, Kim K: Rhinoplasty, In Griffin J, Kim K: Cosmetic Surgery for the Oral and Maxillofacial Surgeon. Quintessence Publishing Co, 2010, pp. 1-30
Chin KY, Uppal R: Improved access in endonasal rhinoplasty: the cross cartilaginous approach. J Plast Reconstr Aesthet Surg 67(6):781- 8, 2014
Coskun BU, Sozen E, Seneldir S, Ozkaya I, Yildirim O, Korkut AY, Dadas B: Does the open rhinoplasty incision decrease nasal pro- jection? Eur Arch Otorhinolaryngol 269(3):867-70, 2012
Cuzalina A: Rhinoplasty, In Niamtu J:Cosmetic Facial Surgery. Mosby, 2011, pp. 175-246
Daniel RK: Tip refinement grafts: The designer tip. Aesthetic Surgery Journal 29(6):528-537, 2009
Filho ACNN, Romano G, Ribas DB, Sass SMG, Franceschi E: Nasal tip narrowing: Minimally invasive suture technique for thick nose tip. Int Arch Otorhinolaryngol 15(3):302-307, 2011
Gunel C, Omurlu IK: The effect of rhinoplasty on psychosocial distress level and quality of life. Eur Arch Otorhinolaryngol 272(8):1931- 5, 2014
Harel M, Margulis A: Dorsal augmentation with diced cartilage enclosed with temporal fascia in secondary endonasal rhinoplasty. Aesthet Surg J 33(6):809-16, 2013
Harrison DH: Reflections on the open and closed rhinoplasty. J Plast Reconstr Aesthet Surg 66(10):1356-9, 2013
Kamburoglu HO, Kayikcioglu AU: Closed rhinoplasty with open ap- proach advantages: extended intranasal incisions and tip re- arrangement sutures. Aesthetic Plast Surg 38(4):653-61, 2014
Kim HS, Park SS, Kim MH, Kim MS, Kim SK, Lee KC: Problems associ- ated with alloplastic materials in rhinoplasty. Yonsei Med J 55(6):1617-23, 2014
Marimuthu M, Bonanthaya K, Shetty P, Wahab A: Open versus closed rhinoplasty with primary cheiloplasty: A comparative study. Journal of Maxillofacial and Oral Surgery 12(3):289-296, 2013
Masuoka H, Kawai K, Morimoto N, Yamawaki S, Kawazoe T, Suzuki S: Conchal cartilage graft for correction of bilateral cleft lip nasal de- formities during childhood. Plast Reconstr Surg Glob Open 2(2):e104, 2014
Ozkul T, Ozkul MH: Computer simulation tool for rhinoplasty planning. Comput Biol Med 34(8):697-718, 2004
Palma P, Khodaei I, Bertossi D, Vasilenko I, Alqahtani A, Alaa Shawkat S, Wills Villarraga D: Hybrid rhinoplasty: beyond the dichotomy of rhinoplasty techniques. Acta Otorhinolaryngol Ital 33(3):154- 62, 2013
Park SG, Jeong H, Ye CH: Multifactorial approaches for correction of the drooping tip of a long nose in East asians. Arch Plast Surg 41(6):630-7, 2014
Scattolin A, D'Ascanio L: Grafts in "closed" rhinoplasty. Acta Otorhi- nolaryngol Ital 33(3):169-76, 2013
Scattolin A, Orlando N, D'Ascanio L: Spreader graft in closed rhino- plasty: the "rail spreader". Facial Plast Surg 29(6):515-9, 2013
Tas S: A new way for supporting tip projection in closed rhinoplasty: using the medial deep SMAS layer. Plast Reconstr Surg 133(1):76-7, 2014 Triaca A, Gaggl A, Borumandi F: Osteochondral nasal dorsum flap in open rhinoplasty. Br J Oral Maxillofac Surg 52(10):980-2, 2014
Department of Oral and Maxillofacial Surgery, Dental School, Aristotle University of Thessaloniki, ‘G. Papanikolaou’ General Hospital of Thessaloniki, (Head: Professor K. Antoniadis)
Hellenic Archives of Oral & Maxillofacial Surgery (2017) 2, 47-56
SUMMARY: The form and shape of the nose is an es- sential component of facial aesthetics, affecting indirectly the mental state and the personality development of the patient. The restoration of shape deformities and func- tional disorders are corrected by surgical procedures of open and closed rhinoplasty.
We present the basic principles of the closed rhinoplasty and our experience in restoring nasal deformities as nasal hump, with the method of closed rhinoplasty. Twenty patients underwent rhinoplasty from 1993 to 2013 using the closed method. Preoperative photographs were taken and a computer-simulated procedure was used to predict the outcome of rhinoplasty.
The results were satisfactory both immediately after surgery and at a later time. The evaluation was done both by the patients themselves and by the surgeon.
The closed rhinoplasty is a surgical technique with fewer complications as postoperative swelling, and better aes- thetics because of the absence of external scar. The access provided to the osteochondral skeleton of the nose, although it is limited, when proper preoperative evaluation is done, in the hands of surgeons with appropriate experience and expertise, can be the method of choice to repair deformities of the nose.
KEY WORDS: closed rhinoplasty, nasal hump, approach, nasal bones, outcome evaluation
REFERENCES
Abbou R, Bruant-Rodier C, Wilk A, Meningaud JP, Khan JL, Bosc R, Bodin F: Open rhinoplasty: influence of incisions, alar resection, and columellar strut on final appearance of the tip. Aesthetic Plast Surg 38(6):1077-82, 2014
Adelson R, DeFatta R, Bassischis B: Objective assessment of the accu- racy of computer-simulated imaging in rhinoplasty. American Jour- nal of Otolaryngology 29(3):151-155, 2008
Αηδόνης Α: Χειρουργική του ρινικού διαφράγματος και ρινοπλαστική. Εκδόσεις ‘Μαίανδρος΄, Θεσσαλονίκη , 1993, σελ. 74 -80.
Baker SR: Suture contouring of the nasal tip. Arch Facial Plast Surg 2(1):34-42, 2000
Bowles PF, Fu B, Cartwright SJ, Watts SJ: An alternative approach to primary rhinoplasty using Walsham forceps. J Laryngol Otol 128(11):1003-4, 2014
Caloss R, Kim K: Rhinoplasty, In Griffin J, Kim K: Cosmetic Surgery for the Oral and Maxillofacial Surgeon. Quintessence Publishing Co, 2010, pp. 1-30
Chin KY, Uppal R: Improved access in endonasal rhinoplasty: the cross cartilaginous approach. J Plast Reconstr Aesthet Surg 67(6):781- 8, 2014
Coskun BU, Sozen E, Seneldir S, Ozkaya I, Yildirim O, Korkut AY, Dadas B: Does the open rhinoplasty incision decrease nasal pro- jection? Eur Arch Otorhinolaryngol 269(3):867-70, 2012
Cuzalina A: Rhinoplasty, In Niamtu J:Cosmetic Facial Surgery. Mosby, 2011, pp. 175-246
Daniel RK: Tip refinement grafts: The designer tip. Aesthetic Surgery Journal 29(6):528-537, 2009
Filho ACNN, Romano G, Ribas DB, Sass SMG, Franceschi E: Nasal tip narrowing: Minimally invasive suture technique for thick nose tip. Int Arch Otorhinolaryngol 15(3):302-307, 2011
Gunel C, Omurlu IK: The effect of rhinoplasty on psychosocial distress level and quality of life. Eur Arch Otorhinolaryngol 272(8):1931- 5, 2014
Harel M, Margulis A: Dorsal augmentation with diced cartilage enclosed with temporal fascia in secondary endonasal rhinoplasty. Aesthet Surg J 33(6):809-16, 2013
Harrison DH: Reflections on the open and closed rhinoplasty. J Plast Reconstr Aesthet Surg 66(10):1356-9, 2013
Kamburoglu HO, Kayikcioglu AU: Closed rhinoplasty with open ap- proach advantages: extended intranasal incisions and tip re- arrangement sutures. Aesthetic Plast Surg 38(4):653-61, 2014
Kim HS, Park SS, Kim MH, Kim MS, Kim SK, Lee KC: Problems associ- ated with alloplastic materials in rhinoplasty. Yonsei Med J 55(6):1617-23, 2014
Marimuthu M, Bonanthaya K, Shetty P, Wahab A: Open versus closed rhinoplasty with primary cheiloplasty: A comparative study. Journal of Maxillofacial and Oral Surgery 12(3):289-296, 2013
Masuoka H, Kawai K, Morimoto N, Yamawaki S, Kawazoe T, Suzuki S: Conchal cartilage graft for correction of bilateral cleft lip nasal de- formities during childhood. Plast Reconstr Surg Glob Open 2(2):e104, 2014
Ozkul T, Ozkul MH: Computer simulation tool for rhinoplasty planning. Comput Biol Med 34(8):697-718, 2004
Palma P, Khodaei I, Bertossi D, Vasilenko I, Alqahtani A, Alaa Shawkat S, Wills Villarraga D: Hybrid rhinoplasty: beyond the dichotomy of rhinoplasty techniques. Acta Otorhinolaryngol Ital 33(3):154- 62, 2013
Park SG, Jeong H, Ye CH: Multifactorial approaches for correction of the drooping tip of a long nose in East asians. Arch Plast Surg 41(6):630-7, 2014
Scattolin A, D'Ascanio L: Grafts in "closed" rhinoplasty. Acta Otorhi- nolaryngol Ital 33(3):169-76, 2013
Scattolin A, Orlando N, D'Ascanio L: Spreader graft in closed rhino- plasty: the "rail spreader". Facial Plast Surg 29(6):515-9, 2013
Tas S: A new way for supporting tip projection in closed rhinoplasty: using the medial deep SMAS layer. Plast Reconstr Surg 133(1):76-7, 2014 Triaca A, Gaggl A, Borumandi F: Osteochondral nasal dorsum flap in open rhinoplasty. Br J Oral Maxillofac Surg 52(10):980-2, 2014
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