Hopkins reunion
Every two years the Johns Hopkins Medical and Surgical Association holds a reunion in Baltimore. This year was different because it was not only a reunion but also a celebration of Paul Manson's tenure as chief of plastic surgery and his impending retirement after a third of a century at Hopkins, a period that began in 1976, his first year of residency. (Source: Journal of Plastic, Reconstructive & Aesthetic Surgery)...
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Through the mists of time:
Puthumana Philip PhilipIndian Journal of Plastic Surgery 2009 42(2):219-223Sushrutha had been viewed in textbooks of plastic surgery as belonging to the caste of potters who performed surgery in India. We have examined the available source documents and other references to the technology of the period to examine this assertion and are convinced that there is no evidence to support this. The period, technology and geographic references in Sushrutha Samhitha are correlated with settled positions on these to arrive at an understanding of the time and knowledge which is described. Source of erroneous interpretation of Sushrutha as a potter is also examined and clarified. (Source: Indian Journal of Plastic Surgery)...
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Index
(Source: Clinics in Plastic Surgery)...
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Problems in Rhinoplasty
In this review, the complications of rhinoplasty are examined in terms of their timing of presentation. An algorithmic approach to postoperative problems is discussed. Complications can frequently be avoided by meticulous technique, recognition of pitfalls, and early attention to perioperative morbidity. Reoperative rates can be minimized with good patient education and proper command of the postoperative situation, so that unnecessary procedures are not undertaken. (Source: Clinics in Plastic Surgery)...
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Secondary Rhinoplasty and the Use of Autogenous Rib Cartilage Grafts
This article discusses the steps involved in the external approach to secondary rhinoplasty. (Source: Clinics in Plastic Surgery)...
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Ethnic Rhinoplasty
As the United States becomes more racially and ethnically diverse, the number of non-Caucasian patients seeking rhinoplasty is increasing. The non-Caucasian, or ethnic, rhinoplasty patient can be a surgical challenge due to the significant anatomic variability from the standard European nose as well as variability within each ethnicity. Becoming familiar with the common anatomic differences as well as the aesthetic goals in the ethnic rhinoplasty patient will assist the surgeon in attaining consistent, ethnically congruent, and aesthetically pleasing results. (Source: Clinics in Plastic Surgery)...
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Asian Rhinoplasty
Asian rhinoplasty differs from traditional rhinoplasty approaches in preoperative analysis, patient expectations, nasal anatomy, and surgical techniques used. Platyrrhine nasal characteristics are common, with low dorsum, weak lower lateral cartilages, columellar retraction, and thick sebaceous skin often noted. Typically, patients seek augmentation of these existing structures rather than reductive procedures. Autologous cartilage, in particular use of costal cartilage, has been shown to be a reliable technique, which, when executed properly, produces excellent long-term results. An understanding of cultural perspectives, knowledge of the nasal anatomy unique to Asian patients, and proficiency with augmentation techniques are prerequisites in attaining the desired results for patient and ......
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Lengthening the Short Nose
Lengthening the short nose is a challenging area of rhinoplasty. The short nose can be a naturally occurring aesthetic disproportion, or the result of a congenital abnormality or traumatic deformity. The surgical approach depends mostly on the quality of the lining, skeleton, overlying skin, and the amount of correction desired. (Source: Clinics in Plastic Surgery)...
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Osteotomies
The most challenging and instrumental step in achieving harmonious form and function during rhinoplasty is the successful completion of osteotomies. Osteotomies are performed to correct deformities of the bony nasal vault. Successful treatment of deformity of the bony vault is achieved through organized thinking, comprehensive knowledge of nasal anatomy, and thorough preoperative and intraoperative planning. In this review the authors discuss the pertinent anatomy, technical considerations, and complications that rhinoplasty surgeons should be aware of to optimize the correction of deformities of the nasal bony vault. (Source: Clinics in Plastic Surgery)...
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Rhinoplasty: Dorsal Grafts and the Designer Dorsum
This article reviews the author's different approaches to dorsal grafts using fascia and diced cartilage, either separately or in combination. (Source: Clinics in Plastic Surgery)...
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Humpectomy and Spreader Flaps
In a primary rhinoplasty that requires a humpectomy, the dorsal aspect of the upper lateral cartilages is commonly discarded. Many of these patients need spreader grafts to reconstruct the middle third of the nose. However, it is possible to reconstruct the upper lateral cartilages into “spreader flaps” that act much like spreader grafts. In the process of making spreader flaps, an incremental humpectomy is performed on the dorsal septum and bony hump. This humpectomy procedure is more accurate than the conventional humpectomy that involves resection of the bone, and septum as a single unit. The open and closed approaches of this technique are discussed in this article. (Source: Clinics in Plastic Surgery)...
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Rhinoplasty5 Pearls: Value of the Endonasal Approach and Vertical Dome Division
Successful outcomes in rhinoplasty depend more on diagnosis than on approach or technique. When the needs of each patient are assessed on multiple occasions, operative performance improves and revision rates decline. The evolutionary track from an endonasal and excisional operation to the more commonly preferred external and restructuring technique is outlined in this article. The senior author's rationale and preference for the endonasal approach and the repositioning of cartilage in the tip using vertical dome division techniques is emphasized. (Source: Clinics in Plastic Surgery)...
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Alar Base Disharmonies
This article simplifies the recognition of common alar base disharmonies. The classification system is intended to facilitate choosing the best surgical technique to correct the alar base flaws. (Source: Clinics in Plastic Surgery)...
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Suture Techniques in Rhinoplasty
Suture techniques are an indispensable means to biologically sculpt the cartilage of the nose. Here the authors review their use in tip-plasty and present a 4-suture algorithm that allows for simple, complete control in sculpting the shape of all nasal tips in primary rhinoplasty. After a standard cephalic trim of the lateral crus leaving it 6 mm wide, one or more of the four suture techniques are applied. One of the newest techniques that has yielded excellent results is the hemi-transdomal suture, a variation of the conventional transdomal suture. This technique narrows the dome but also everts the lateral crus slightly to avoid concavities of the nostril rim. The 4-suture algorithm is useful in both the open and closed approaches. A more general use of sutures is described and referred ......
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Diagnosis and Correction of Alar Rim Deformities in Rhinoplasty
Recognition of alar rim deformities is an important component of the preoperative analysis of the nose. Correction of these deformities improves the esthetic balance of the nose and has an added benefit of improving the function of the external nasal valve. Classification systems have been proposed to enable surgeons to more accurately diagnose alar deformities. These classification systems help guide surgeons as to the appropriate surgical procedure to correct a problem. The purpose of this article is to review the proposed classification systems for alar rim deformities and review the specific surgical techniques that have been proposed for each of the deformities. (Source: Clinics in Plastic Surgery)...
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Principles of Photography in Rhinoplasty for the Digital Photographer
This article reviews the basic principles of photography and discusses their application to facial plastic surgery practice, and rhinoplasty in particular. (Source: Clinics in Plastic Surgery)...
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Nasal and Facial Analysis
Rhinoplasty remains one of the most challenging aesthetic procedures to master. Astute surgeons must consider a continually evolving societal perception of beauty with their own sense of aesthetic proportion when planning surgical intervention. Optimal results are achieved when the outcome is anticipated and satisfying to patient and surgeon. This requires a careful, thoughtful, systematic approach to preoperative analysis. Patients should leave with a clear understanding of the surgeon's perspective of their nose, aesthetically and anatomically. Understanding the interplay of surface deformities and their underlying anatomic counterpart is critical, involving a systematic analysis to create a surgical plan that avoids landmines leading to a suboptimal result. (Source: Clinics in Plastic S......
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Preface
For a number of reasons, rhinoplasty is arguably the most intricate and challenging operation in all of aesthetic plastic surgery. Because the nose is a relatively small structure, a millimeter change makes a discernible difference in its aesthetics. It is located in the middle of the face, constantly available for inspection by the patient and others. The magnitude of the effects of the healing process often equals and occasionally exceeds the magnitude of the changes that the surgeon is seeking to make. Indeed, the healing process can completely distort the sculptured result the surgeon has achieved. Furthermore, almost every surgeon knows what an aesthetically pleasing nose looks like when he or she sees it. However, not every surgeon intuitively understands what components of the nose ......
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Forthcoming Issues
(Source: Clinics in Plastic Surgery)...
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Contents
(Source: Clinics in Plastic Surgery)...
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