ARtiCLe | RHINOPLASTY |


Frédéric Braccini discusses the newer techniques in the specialty of rhinoplasty, as well as presenting an overview of the basic anatomical features of the nasal area


FREDERIC BRACCINI is a facial plastic surgeon at Facial Plastic Surgery, HNS & FPS Riviera Institute, Nice, France


Contributing author: DR ALESSIO REDAELLI MILANO


contact: www.braccini.net


ABSTRACT The surgical procedure of rhinoplasty is one of the most interesting and complex aesthetic surgeries. The main goal of aesthetic and artistic rhinoplasty is to achieve a natural look of beauty enhancement to create a harmonious face. There is no one standard rhinoplasty procedure, but many rhinoplasties that must suit to each individual patient. Everyone demands a better sense of wellbeing and self-confidence in the quest of beauty. Rhinoplasty aims to improve facial aesthetics, as well as nasal breathing function, which is also an important factor for patients. Rhinoplasties have evolved in much the same way as other plastic surgery procedures: more radical; more preserving of the function; and a simplified concept and procedure. Rhinoplasty procedures are simplified through the objective of reducing surgical trauma and optimising down time. It remains a surgical act, but newer fields of aesthetic medicine modify its philosophic and technical approach. Furthermore, approaches which propose an external technique and large dissection are now becoming much less common. In this article, the author describes his own surgical strategies and the place of non-surgical solutions to modify the appearance of the nose.


A


Figure 1 Incisions using an endonasal


transcartilaginous approach


KEYWORDS rhinoplasty, surgery, dermal fillers, hyaluronic acid, botulinum toxin, aesthetic


36 ❚ September 2011 | prime-journal.com


FULL AnALysis oF the nose is necessary before undertaking any surgery, but the nasal tip is a key aspect of facial harmony. it is mobile and this depends on the muscle activity of both the nasal spine area and nostril area. the


nasal position is of great importance for an harmonious facial balance. the shape and position of the nasal tip, therefore, are defined by static and dynamic anatomical structures that the facial plastic surgeon has to understand for a precise correction and a successful outcome.


iN rhiNoplasty: soft surgery to the medical approach


New treNds The skin and its thickness also play a role in the shape


of the tip and its contours. The nasal tip must be analysed both as part of the nose and as an individual anatomical structure. The base of the nose should be analysed at the same time as it holds the tip in position and assists in aspects of mobility. Nasal tips are defined by their projection, rotation and contour definition. The tip projection is adequate when 50–60% of the


nasal tip is located in front of the vertical line passing through the upper lip, and also when the tip is ideally equal to 60–65% of the nasal length (measured from the naso-frontal angle to the tip). This article describes the main principles of the


mini-rhinoplasty and analyses the place of non-surgical procedures and techniques in the aesthetics of the nose.


The mini-rhinoplasty First described by French facial plastics surgeons1–3


, the


mini-rhinoplasty technique is a quick, simple, and reproducible procedure. It is a reduction rhinoplasty, which can be carried out in a 1-day surgery.


Method The experience of the author, based on more than 1000 mini-rhinoplasty procedures, is reported, as well as the surgical steps that should be followed2,4


. All successive


technical sequences are essential to perform rhinoplasty in a consistent and reproducible way. The rigor of the


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