RESUMEN
Experience with rhinoplasty over time has shown that a detailed anatomic analysis of the nose is an essential first step in achieving a successful outcome. Failure to recognize a particular anatomic point preoperatively will often lead to a less than ideal long-term result. Deficiency in the radix is a commonly overlooked abnormality that may be found both in patients undergoing primary rhinoplasty and patients undergoing revision rhinoplasty after an overzealous bony hump removal. Whereas surgeons previously reduced the nasal dorsum down to the level of the radix on a routine basis, recent emphasis on a strong natural profile has focused attention on anatomic deficiency in the radix region. We describe a simple technique for treatment of the deep nasofrontal angle and present patient examples. Autologous cartilage grafts may be fashioned into a "radix graft" and reliably used to augment the region either with a precise pocket approach or without when a precise pocket is not possible, achieving a natural aesthetic result.
Asunto(s)
Rinoplastia/métodos , Adulto , Cartílago/trasplante , Estética , Femenino , Humanos , Masculino , Nariz/anatomía & histologíaRESUMEN
Caudal septal deflection can be a challenging nasal deformity. Although there are a number of maneuvers available to manage this functional and aesthetic abnormality, each approach is effective in only a limited number of cases. For over 25 years, the senior author (N.J.P.) has employed a "modified swinging door" technique for treatment of the deviated caudal septum. Using this technique, the septal cartilage along the maxillary crest is dissected free but is not excised. Instead, the caudal septum is flipped over the nasal spine, which acts as a "doorstop" and secures the caudal septum in a straighter position. This maneuver may be useful in the armamentarium of the surgeon managing this potentially difficult technical challenge.
Asunto(s)
Tabique Nasal/anomalías , Procedimientos de Cirugía Plástica , HumanosRESUMEN
The surgeon, medical and nonmedical staff, and the reception, consultation, treatment, surgical, and recovery areas constitute the basic elements of the office operating room complex. In reality these elements are an inseparable dynamic unit; however, for the purpose of discussion they have been examined separately to study their particular aesthetic and nonaesthetic psychological contributions to outpatient surgery. Knowing why a patient forms certain attitudes about the doctor, the office staff, and the office or suite and having some insight into how a patient perceives these same elements are very important to the young practitioner of facial plastic surgery. It is possible that in the contemporary medical world where there are many surgeons of equal ability, success may depend on understanding these psychological aspects.