Abstract:
:Successful rhinoplasty depends on nasal tip support and its influence on nasal tip projection. The factors involved in nasal tip support are numerous; however, the role of the anterior septum versus the lower lateral cartilages has been debated in the literature. The purpose of this study was to quantitate, using fresh cadavers, the critical elements for nasal tip support with open versus closed rhinoplasty techniques. Multiple nasal manipulations, including cephalic trim, cephalic trim and interruption of the lower lateral cartilages, dorsal hump resection (1 to 4 mm), submucous resection of the septum, and complete septal removal, were performed using fresh cadaver heads and using both the open and closed rhinoplasty approach. Changes in nasal tip support were recorded. In comparing similar procedures, the mean loss of tip projection for the open approach was 3.43 mm versus 1.98 mm for the closed approach (p < 0.001). There was a significantly larger loss of tip projection in open versus closed procedures for cephalic trim, cephalic trim and interruption of the lower lateral cartilages, and cephalic trim with interruption of the lower lateral cartilages and septum removal (p < 0.001, 0.001, and 0.001, respectively). We attributed the differences between the open and closed approaches to the increases in ligamentous disruption and skin undermining that occur when using the open approach. Septum manipulation in general resulted in larger losses in tip support in both the open and closed approach. We conclude that the open approach for rhinoplasty results in a significantly increased loss of tip projection when compared with the closed technique due to the larger disruption of ligamentous support. Contrary to previous data, septal manipulation resulted in significant losses of tip projection, most likely secondary to lowering the nasal septal angle, and this effect may be more significant in closed rhinoplasty. The apparent clinical implications are that active measures, such as columellar struts and/or suture techniques for adding or maintaining nasal tip support during rhinoplasty, are indicated, especially when using the open approach and when any anterior septal alteration is performed using the open or endonasal approach.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Adams WP Jr,Rohrich RJ,Hollier LH,Minoli J,Thornton LK,Gyimesi Idoi
10.1097/00006534-199901000-00040subject
Has Abstractpub_date
1999-01-01 00:00:00pages
255-61; discussion 262-4issue
1eissn
0032-1052issn
1529-4242journal_volume
103pub_type
杂志文章abstract::There are several structures involved in columellaplasty, and all affect the support and shape of the tip, the columella, and the upper lip. The present paper considers only the problem of the deformities of the maxillary spine and its lower extension over the midline, causing broadening and asymmetrical development o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198111000-00003
更新日期:1981-11-01 00:00:00
abstract:BACKGROUND:Multiple orbital aging models have been suggested to explain the progressive development of lower eyelid prominence. Objective data to support these theories are limited, however. METHODS:Orbital anatomy was measured with high-resolution orbital magnetic resonance imaging in the quasi-sagittal plane paralle...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181811ce8
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The frontalis is a representative target muscle for botulinum neurotoxin type A injections aimed at treating horizontal wrinkles in the forehead region. However, a lack of information regarding the shape and thickness of the frontalis may lead to unexpected side effects. METHODS:This study dissected hemifac...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005202
更新日期:2019-02-01 00:00:00
abstract::Of four patients with rheumatoid arthritis and Dupuytren's contracture, two were not aware of the presence of Dupuytren's contracture. When both diseases coexist, the presence of rheumatoid hand deformities, especially flexion and ulnar deviation of the metacarpophalangeal joints, may mask the flexion deformity caused...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198801000-00010
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:During breast reconstruction using the transverse rectus abdominis myocutaneous (TRAM) flap, the use of mesh for abdominal donor-site closure provides for a technology that potentially offers clinical benefit yet incurs an added cost. The authors' goal was to determine whether it is cost effective to use mes...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000000957
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:"Disruptive physician" is a term appearing more frequently in many hospital bylaws. It has significant negative implications that can lead to loss of privileges for plastic surgeons. METHODS:Exploring the various definitions of disruptive physician reveals palpable differences between those of the Joint Com...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31819348bd
更新日期:2009-01-01 00:00:00
abstract::The malposition of an otherwise normal-appearing external ear is not uncommon in certain craniofacial syndromes. This paper presents a 10-year experience of 14 patients who underwent external ear repositioning. In this technique, a posterior incision is used to mobilize surrounding soft tissues circumferentially aroun...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199007000-00021
更新日期:1990-07-01 00:00:00
abstract::The Internet was evaluated as a source of information for the layperson on the topic of breast augmentation. Three commonly used search engines (Excite, AOL, and Yahoo) were employed using the term "breast augmentation." These sites were then evaluated by each of three experienced plastic surgeons for their quality an...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200101000-00028
更新日期:2001-01-01 00:00:00
abstract::A case is presented of a congenital nasal deformity consisting of a midline nasal muscle, alar cartilage defect, and partially obstructed nostril. The embryology of nasal development is reviewed, and an attempt is made to explain this unique anomaly. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198103000-00015
更新日期:1981-03-01 00:00:00
abstract:BACKGROUND:Postoperative cosmetic deformities can be encountered after surgical treatments for upper eyelid retraction. The authors described a preaponeurotic fat advancement technique and investigated the effectiveness in patients who underwent levator recession for upper lid retraction. METHODS:This retrospective co...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001099
更新日期:2015-04-01 00:00:00
abstract::Skin-sparing mastectomy by definition describes the procedure of mastectomy, either simple or modified radical, with a minimum amount of skin excision. The surgical skin excision must: (1) include the nipple-areola complex, (2) include the biopsy site, and (3) allow for access to the axilla for possible dissection. In...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::Use of the open rhinoplasty technique (ORT) in certain nasal and septal deformities has proven to be an invaluable asset in the rhinoplasty armamentarium of the authors. Primarily owing to the markedly increased exposure with this technique, more accurate assessment of the deformities is possible and additional or imp...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198812000-00006
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:Therapies to improve outcomes following peripheral nerve injury are lacking. Prolonged denervation of muscle and Schwann cells contributes to poor outcomes. In this study, the authors assess the effects of growth hormone therapy on axonal regeneration, Schwann cell and muscle maintenance, and end-organ reinn...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002188
更新日期:2016-06-01 00:00:00
abstract::Intralesional corticosteroid injections were performed in 31 hemangiomas in 30 infants aged 1 to 10 months at first injection. One to five injections were given, spaced 6 weeks apart. Lesions were located throughout the head and neck region, except one that was on the buttock. A mixture of betamethasone acetate and tr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198903000-00009
更新日期:1989-03-01 00:00:00
abstract::Recent reports have emphasized free-flap reconstruction for large defects of the scalp and calvarium following resection of tumors, infection, or trauma. In most cases, however, a carefully planned local transposition or rotation flap may be equally effective, and the technical difficulties and donor-site problems ass...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199304001-00005
更新日期:1993-04-01 00:00:00
abstract::Outcomes research examines the end results of medical interventions, taking into account patients' experiences, preferences, and values. The purpose of assessing outcomes is to provide evidence on which to base clinical decisions. The assessment of outcomes in aesthetic surgery is especially pertinent because patient ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,meta分析
doi:10.1097/01.PRS.0000036041.67101.48
更新日期:2003-01-01 00:00:00
abstract::Reconstruction for polysyndactyly of the toes aims at cosmetic improvement. A previous method that uses a skin graft has inherent disadvantages of mismatched pigmentation between the graft and the surrounding skin and scar formation at the donor site. The authors' new improved surgical technique for the treatment of p...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000131882.19567.65
更新日期:2004-08-01 00:00:00
abstract::A technique for coverage of periolecranon (elbow) defects is presented. The technique uses the local tissues of the lateral upper arm as an axial flap and minimizes the donor defect for this type of reconstruction by obviating the need for a skin graft. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Craniofacial injuries secondary to earthquake-related trauma are uncommonly reported and can pose a significant reconstructive challenge. The objective of this study is to report and analyze earthquake-related craniofacial injury reconstruction and the disaster relief capabilities of a U.S. Navy hospital shi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181f5272d
更新日期:2010-12-01 00:00:00
abstract::Nasal deformity in unilateral cleft lip and palate patients increases with time, tongue malposition being one of the causes. Some authors have emphasized the role of nasal and adjacent facial musculature as active extrinsic agents. Another cause of alar deformity can be the lack of a proper foundation because of a max...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199909030-00002
更新日期:1999-09-01 00:00:00
abstract::Two cases of unusually giant lipomas--weighting 5070 and 4000 gm--are described. Tumors were present for 5 years on the back in a 55-year-old man and for 20 years at the anterior compartment of the thigh in an 80-year-old woman. Difficulty in fitting clothes was the first patient's sole complaint, and social pressure ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199408000-00025
更新日期:1994-08-01 00:00:00
abstract::This article describes the results of segmental bone and cartilage reconstruction of significant nasal dorsal defects. Solid bone graft reconstructions frequently lead to an unnatural hardness of the nasal tip. Rib cartilage reconstructions are pliable and soft but are a problem because they easily undergo warpage. Th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200007000-00032
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:When the results of breast augmentation surgery are evaluated, the respective points of view of the surgeon and the patient can differ. Because of the nature of plastic surgery, evaluation of the results puts more emphasis on the patient's satisfaction than on medical knowledge. Among the patients who are sa...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000246235.00439.3d
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:This study evaluated patients who underwent primary breast surgery within a single group practice from 1994 to 2009. Reoperations were divided by reoperation reason into total reoperations and implant-specific reoperations. The authors hypothesized that the implant-specific reoperation rate will provide the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318205f41b
更新日期:2011-03-01 00:00:00
abstract::Prosthetic vascular complications such as exposure and infection represent one of the most challenging and devastating complications in surgery. Nineteen patients underwent a retrospective review of the efficacy of soft-tissue flap coverage in the management of vascular prostheses complications. These patients were di...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract::The recent report of a transforming growth factor-beta 3 (TGF-beta 3) knock-out mouse in which 100 percent of the homozygous pups have cleft palate raised the question as to the potential usefulness of these animals as a model for cleft palate research. The specific aim in this study was to carefully document the anat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200109150-00018
更新日期:2001-09-15 00:00:00
abstract::The coverage of large soft-tissue defects usually requires a large flap transfer, especially in a combination and expanded form. However, some large soft-tissue defects still cannot be covered by such flaps. In this article, we present a case of a civil war injury in a patient from Afghanistan who had severe trauma to...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200008000-00024
更新日期:2000-08-01 00:00:00
abstract::A new operative technique is described in which the natural curved nasal dorsum is retained in a modified fashion. Specifically, the nasal dorsum is elevated, the nasal height is reduced, and then the newly designed roof is lowered. Based on a minimum 1-year follow-up of 14 patients and a total experience of 28 patien...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND:Previous studies assessing outcomes following orthognathic surgery rely primarily on single-center/surgeon experience. In addition to issues of generalizability, these studies are limited in evaluating the effect of operative volume on patient outcomes. METHODS:Orthognathic procedures were identified in the...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/PRS.0000000000002384
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the efficacy of postoperative intense pulsed light therapy on patients who undergo bilateral eyelid surgery. METHODS:Patients presenting over a 3-month period for bilateral eyelid surgery were asked to participate in an institutional review board-approved study. Int...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/PRS.0000000000002086
更新日期:2016-05-01 00:00:00