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Dent Clin North Am 2022 Jul 31;66(3):343-360. Epub 2022 May 31.

Oral and Maxillofacial Surgery Department, University of Louisville, Louisville, KY, USA.

The oral and maxillofacial surgeon (OMS) has the knowledge and skills to make drastic skeletal changes in favor of a more cosmetic smile. OMS can alter intraoral and extraoral soft tissues to make subtle or significant changes in facial cosmesis. This article provides an overview of the scope of the OMS in smile design. Read More

J Craniofac Surg 2022 May;33(3):e257-e260

Gaziosmanpaşa Training and Research Hospital ENT Clinic, Turkey.

Objective: Nasal obstruction after rhinoplasty occurs due to narrowing of the internal nasal valve. Narrowing is due to osteotomy performed to close the open roof of nose after dorsum hump resection. Spreader grafts and autospreader flaps are used to prevent such narrowing. Read More

Facial Plast Surg Aesthet Med 2022 May-Jun;24(3):143-159

Department of Otolaryngology-Head & Neck Surgery, Rush University Medical School, Chicago, Illinois, USA.

Augmentation of the nasal dorsum is frequently required in the ethnic rhinoplasty patient to create a narrowing effect and to balance the upper two thirds of the nose with the desired increase in tip projection. The subdorsal cantilever graft (SDCG) provides a method to elevate the nasal dorsum to complement the increase in nasal tip projection. SDCG type A is situated below the bony dorsum and acts to raise the dorsum with limited elevation of the radix. Read More

Ann Chir Plast Esthet 2022 Jun 4. Epub 2022 Jun 4.

Department of Anesthesia, College of Health Sciences, University of Duhok, Kurdistan Region, Iraq.

Background: Preservation rhinoplasty resulted in a major change in the philosophy of rhinoplasty surgery, it include 3 main elements: elevation of a sleeve of skin from the subperichondrial-subperiosteal plane, preservation of the osseo-cartilaginous dorsum, and maintaining the alar cartilages with minimum excision while achieving the desired shape using sutures.

Patients And Methods: This is prospective study included 113 patients who underwent dorsal preservation rhinoplasty for nasal hump treatment. Patients were followed for 15months after surgery. Read More

Plast Reconstr Surg 2022 Jun 6. Epub 2022 Jun 6.

Karakoçan State Hospital, Department of Otorhinolaryngology/Head and Neck Surgery, Elaziğ, Turkey.

Background: Crooked nose deformity is defined as any degree of deviation of the anatomical structures involving the nasal bone, upper and lower lateral cartilages, and the septum from the midsagittal plane of the face, in any direction.

Methods: This study introduces a new technique to correct crooked nose deformity. Twenty-six with I-shaped, C- and reverse C-shaped, and S-shaped crooked nose deformity underwent open approach rhinoplasty. Read More

Aesthetic Plast Surg 2022 Apr 27. Epub 2022 Apr 27.

Department of Plastic Surgery, Peking University Third Hospital, No.49 North Garden Road, Haidian District, Beijing, 100191, China.

Most Chinese have unpleasant facial profile of midfacial depression, which could be caused by multiple reasons. In the past, LeFort osteotomy and orthodontic methods were applied for surgical treatment of midfacial concavity. As the development of plastic surgery filling techniques, nasal base filling or concurrent comprehensive rhinoplasty has been widely used to improve midfacial depression. Read More

Plast Reconstr Surg 2022 05 26;149(5):901e-904e. Epub 2022 Apr 26.

From the Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédias Abel Salazar, Universidade do Porto, Hospital da Luz Arrábida; and Plastic Surgery Division, Faculty of Medicine, University of São Paulo.

Summary: For V-shaped nasal bones, the authors consider that ostectomy of the dorsal keystone area can be avoided, and this has led to the development of a new preservation technique: the spare roof technique B (or Ferreira-Ishida technique), where the bony cap is preserved. It includes six main steps, as follows. Step 1, draw on the surface of the skin the desired dorsal brow-tip aesthetic lines, the pyriform aperture, the rhinion, and the amount of triangular bone that has to be taken out to allow pushing-down the bony cap, and the transversal line in the beginning of the nasal hump. Read More

Ann Plast Surg 2022 05 18;88(5):480-484. Epub 2022 Feb 18.

From the Department of Plastic and Reconstructive Surgery.

Introduction: Nasal osteotomy is a powerful cornerstone step in almost all rhinoplasty procedures and is a major cause of postoperative periorbital ecchymosis and edema after rhinoplasty. Different accesses for osteotomy have been described, the most popular of which is the external perforating and the internal continuous methods. These accesses are blind maneuvers and have some drawbacks such as possible visible scar formation in the percutaneous access or high rate of mucosal tear in the endonasal access. Read More

Aesthet Surg J 2022 Apr 20. Epub 2022 Apr 20.

Department of Plastic Surgery, University of California, Irvine, Irvine, CA.

Background: Preservation rhinoplasty (PR) is an evolving philosophy.

Objectives: The open approach was used initially, but the author felt a closed approach might be of benefit in certain patients.

Methods: One hundred sixty-two primary rhinoplasty cases were studied retrospectively between January and July 2020. Read More

Aesthetic Plast Surg 2022 Mar 17. Epub 2022 Mar 17.

Department of Plastic Surgery, Atribeaute Clinic, St. Petersburg State Pediatric Medical University, Tverskaya 1, Liter A, Saint-Petersburg, Russia, 191015.

J Plast Reconstr Aesthet Surg 2022 Apr 19;75(4):1497-1520. Epub 2022 Jan 19.

Medical University of Lodz, Uniwersytet Medyczny w, Ringgold, ID, Lodzi 37808, Poland.

Int J Otolaryngol 2022 14;2022:3054767. Epub 2022 Feb 14.

DWA Energy Limited, Lincoln, UK.

Background: Rhinoplasty is one of the most common types of cosmetic surgery undertaken. In most rhinoplasty patients, an osteotomy is used to reshape the nasal pyramid. The most common complications following osteotomy are edema and ecchymosis. Read More

Aesthetic Plast Surg 2022 Feb 15. Epub 2022 Feb 15.

Plastic Surgeon in a Private Practice in Baku, Baku, Azerbaijan.

Background: The application of piezoelectric instruments (PEIs), which made the work with the nasal pyramid a predictable and controlled stage of rhinoplasty, is still more often related to the open approach. The intranasal approach is constantly associated with standard methods of osteotomies, including percutaneous techniques, which represent certain limitations in working with the bony vault without managing the surface and thickness of its walls and the risk of uncontrolled fractures.

Objectives: The authors apply PEIs for osteotomies and reshaping of the nasal pyramid through the closed approach with preservation rhinoplasty and complete subperichondrial and subperiosteal dissection. Read More

Aesthetic Plast Surg 2022 Feb 2. Epub 2022 Feb 2.

Department of Otorhinolaryngology, Educational - Surgical clinic of Azerbaijan Medical University, Azerbaijan Medical University, Mirgasimov Street, 1004, Baku, Azerbaijan.

Background: Although the different techniques and instruments described for lateral osteotomies date back decades, the literature on deciding the position of lateral osteotomies between the sides is limited. In general, the position of lateral osteotomies is decided by frontal view and palpation, but this is not always easy, especially in minimally deviated noses.

Methods: The SELF algorithm, which includes 4 developmentally related parameters, was used to decide the position and number of lateral osteotomies. Read More

J Craniofac Surg 2022 Jan-Feb 01;33(1):101-103

Department of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.

Abstract: Previous literature has documented changes in nasal obstruction after acute LeFort I osteotomy. However, there is a paucity of studies that evaluate distraction-mediated LeFort I (DO-LFI) without concomitant intranasal interventions using the nasal obstruction symptom evaluation (NOSE) scale in Class III patients. The purpose of this study is to objectively evaluate nasal obstruction quality of life through the NOSE scale in patients undergoing DO-LFI. Read More

Facial Plast Surg Aesthet Med 2021 Dec 29. Epub 2021 Dec 29.

Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.

The coronavirus disease 2019 pandemic has led to concerns over transmission risk from head and neck operations including facial cosmetic surgeries. To quantify droplet and aerosol generation from rhinoplasty techniques in a human anatomic specimen model using fluorescein staining and an optical particle sizer. Noses of human anatomic specimens were infiltrated using 0. Read More

J Plast Reconstr Aesthet Surg 2022 Apr 22;75(4):1447-1454. Epub 2021 Oct 22.

Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Korea Mouse Phenotyping Center, Seoul, Republic of Korea; Medical Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Among the materials used for dorsal augmentation rhinoplasty (DAR), cross-linked human acellular dermal matrix (ADM) has been claimed for its low risk of infection and extrusion. The aim of this study was to compare the effectiveness of ADM in subjects undergoing primary versus revision dorsal augmentation rhinoplasties.

Methods: Using a retrospective cohort study design, the investigators enrolled a cohort set of DAR patients operated by a single surgeon during a 65-month interval. Read More

Plast Reconstr Surg 2022 Jan;149(1):183-195

From the Division of Plastic Surgery, the Faculty of Medicine, and Division of Otolaryngology, Dalhousie University.

Background: Despite its increasing use in craniofacial surgery, the evidence for piezosurgery over conventional bone-cutting techniques has not been critically appraised. The purpose of this systematic review and meta-analysis was to identify and assess the evidence that exists for the use of piezosurgery in craniofacial surgery.

Methods: A systematic review was undertaken using a computerized search. Read More

J Clin Med 2021 Oct 20;10(21). Epub 2021 Oct 20.

Department of Orthodontics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.

Significant treatment variation exists in the Netherlands between teams treating patients with cleft lip, alveolus, and/or palate, resulting in a confusing and undesirable situation for patients, parents, and practitioners. Therefore, to optimize cleft care, clinical practice guidelines (CPGs) were developed. The aim of this report is to describe CPG development, share the main recommendations, and indicate knowledge gaps regarding cleft care. Read More

Med J (Ft Sam Houst Tex) 2021 Oct-Dec(PB 8-21-10/11/12):55-59

Department of Clinical Investigation, Womack Army Medical Center, Fort Bragg, NC.

Orthognathic surgery has been used to enhance the function of the maxillomandibular complex with numerous positive effects on facial esthetics, as it can profoundly alter the skeletal architecture of the face. Numerous adjunctive surgical techniques are used to enhance the overall cosmetic results of orthognathic surgery to include the following: genioplasty, midface augmentation, rhinoplasty, fillers, and liposuction. Mandibular advancement, submental liposuction and genioplasty are all techniques that help to define the neck throat point (NTP), minimize submental sagging, and enhance throat length (TL) in order to establish a more harmonious facial profile. Read More

Facial Plast Surg 2022 Feb 26;38(1):46-56. Epub 2021 Oct 26.

Department of Facial Plastic Surgery, New York University Medical Center, New York.

Gaining, improving, and maintaining nasal tip projection is one of the most essential elements of successful endonasal rhinoplasty. For years the hallmark of inadequate nasal tip projection following rhinoplasty has been the Polly beak deformity. Early rhinoplasty technique consisted of intracartilaginous excision of the cephalic margin of the lower lateral cartilages, cartilage and bony hump reduction, and osteotomies. Read More

Aesthetic Plast Surg 2022 Apr 1;46(2):830-832. Epub 2021 Oct 1.

Department of Plastic Surgery, St. Petersburg State Pediatric Medical University, Atribeaute Clinic, Tverskaya street, 1 Liter A, Saint-Petersburg, Russia, 191015.

Aesthetic Plast Surg 2022 Apr 29;46(2):805-817. Epub 2021 Sep 29.

Department of Plastic and Burns Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan, 610041, People's Republic of China.

Background: An increasing number of studies have investigated the effect of various methods in avoiding complications in rhinoplasty. Our study aims to analyze the connections between various choices in rhinoplasty and the rate of multiple complications by summarizing results in related meta-analyses.

Materials And Methods: Through Pubmed, MEDLINE, Embase, and the Cochrane Database were associated systematic reviews searched to gather and review the available evidence of different plans and health outcomes in rhinoplasty for this umbrella review. Read More

Laryngoscope 2022 04 28;132(4):769-771. Epub 2021 Sep 28.

Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.

Eur Arch Otorhinolaryngol 2022 Jun 24;279(6):2959-2964. Epub 2021 Sep 24.

Department of Otolaryngology, Giresun Ilhan Ozdemir Research Hospital, 28200, Giresun, Turkey.

Objective: Postoperative comfort of the patients undergoing rhinoplasty might be poor because of edema and ecchymosis caused by lateral osteotomy. In this animal experiment, we aimed at performing a quantitative assessment of effects of hyaluronic acid usage on healing process of lateral osteotomy.

Methods: Fourteen New Zealand rabbits with a weight of 2000-2500 kg and an age of 8-12 weeks were included. Read More

Aesthetic Plast Surg 2021 Sep 7. Epub 2021 Sep 7.

Department of Otorhinolaryngology, Azerbaijan Medical University, Mirgasimov Street, 1004, Baku, Azerbaijan.

Background: Although cartilage tissue is a priority material in both structural grafting and camouflage, in some special cases, there is not enough material for camouflage due to cartilage insufficiency after it is used in structural grafting. In these cases, it is vital that the bony parts of the septum be prepared as a paste graft and applied for camouflage.

Methods: The author retrospectively reviewed 62 rhinoplasty patients in whom septal bony paste grafts were applied during surgery from April 2018 to December 2019. Read More

Natl J Maxillofac Surg 2021 May-Aug;12(2):193-198. Epub 2021 Jul 15.

Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India.

Introduction: The purpose of this study is to highlight the role of cartilage correcting suture in single-stage surgical correction for secondary unilateral cleft lip nose deformity with three-dimensional observations of preoperative and postoperative nasal forms.

Material And Methods: Between July 2017 and June 2019, 18 consecutive patients of unilateral cleft lip nose deformity aged between 16 and 28 years underwent surgical correction. The corrective procedure of nose involved columellar lengthening, medial and lateral nasal osteotomies along with augmentation of premaxilla by bone graft at premaxilla, and alar base wedge resections. Read More

Med Eng Phys 2021 09 13;95:111-116. Epub 2021 Aug 13.

CNRS, Laboratoire de Modélisation et de Simulation Multi Échelle, UMR CRNS 8208, 61 avenue du Général de Gaulle, Créteil 94010, France. Electronic address:

Osteotomies during rhinoplasty are usually based on the surgeon's proprioception to determine the number and the strength of the impacts. The aim of this study is to determine whether a hammer instrumented with a force sensor can be used to classify fractures and to determine the location of the osteotome tip. Two lateral osteotomies were realized in nine anatomical subjects using an instrumented hammer recording the evolution of the impact force. Read More

Facial Plast Surg Aesthet Med 2021 Aug 27. Epub 2021 Aug 27.

Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery Department, Hôpital Henri Mondor, Créteil, France.

Osteotomies during rhinoplasty are usually based on surgeon's proprioception to determine the number, energy, and trajectory of impacts. The first objective was to detect the occurrence of fractures. The second objective was to determine when the thicker frontal bone was encountered by the osteotome. Read More

Aesthet Surg J 2022 02;42(3):249-256

Meram Medical Faculty, Department of Otorhinolaryngology, Necmettin Erbakan University, Konya, Turkey.

Background: Subdorsal septal resection and radix osteotomy are distinctive surgical steps in preservation rhinoplasty.

Objectives: The aim of this study was to evaluate the nasal bone thickness, the level of the septal bony-cartilaginous junction (K area), and the distances of the frontal sinus and skull base from the transverse osteotomy line in the Turkish population by means of conventional computed tomography (CT).

Methods: A retrospective evaluation was made of 203 consecutive preoperative paranasal CT scans of patients (classified in terms of age and gender) who had undergone rhinoplasty surgery between January 2020 and June 2021. Read More