How Nose Surgery is Performed


How Nose Surgery is Performed
http://www.rhinoplastyspecialist.com
Enter the operating room and see first-hand how nose surgery is performed and learn about each specific procedure with Beverly Hills Rhinoplasty Specialist Dr. Paul S. Nassif, a distinguished facial plastic and reconstructive surgeon internationally known for his innovative surgical techniques and expertise in revision & ethnic rhinoplasty.

In this video you’ll discover how Plumping grafts are a helpful technique in correcting a retracted or acute nasolabial angle. The nasolabial angle is the angle formed by the labial surface of the upper lip at the midline and the inferior border of the nose. It is a measure of the relative protrusion of the upper lip.

Ideally, the angle between the upper lip and the nose should be between 90-105 degrees in women, and between 90-95 degrees in men. When this angle is smaller than 90 degrees, it gives the appearance that the tip of the nose is drooping and it can also make the individual seem older than their age.

Correction of this angle with Plumping grafts involves placing bits of the patients own natural cartilage beneath the skin into the lower columella at the base of the nasolabial angle. This can produce cephalic rotation and illusory increased tip projection.

Watch the experience of the patient who underwent this and many other procedures during her ethnic, or westernization, rhinoplasty at…

Dr. Nassif’s practice, Spalding Drive Cosmetic Surgery, is located in Beverly Hills, CA.
http://www.spaldingplasticsurgery.com

OPERATIVE TECHNIQUE:
A pocket down to the nasal spine was made between the medial crura and an extended columellar strut was placed and using 5-0 PDS, the strut was sutured to the medial crura with horizontal mattress sutures while suturing the intermediate crura to the strut which also helped project the nose. Plumping grafts and mucoperichondrium made from diced septal cartilage were placed. The shield graft was fixated to the intermediate crura and dome and a bruised onlay graft and columellar onlay graft were placed caudal to the shield graft with 5-0 PDS horizontal mattress sutures. Combined lateral crural strut grafts/rim grafts were placed on the posterior caudal surface of the lower lateral cartilage and fixated with 5-0 PDS.

African American Nasal Anatomy
Skin: Thick, Abundant Fibrofatty tissue
Radix: Deep, Inferiorly-Set & Low
Nasal Bridge & Dorsum: Short Nasal Bones, Wide & Flat
Tip: Bulbous, Thick-Skinned, Under-Projected, Derotated (Ptotic), Abundant Nasal Soft Tissue, Broad Domes, Minimal Definition
Base: Wide, Thick, Horizontal & Flaring Nostrils
Nasolabial Junction: Retracted, Acute Nasolabial Angle
Maxilla: Usually Retrusive & Hypoplastic

Hispanic Nasal Anatomy
Skin: Thick, Abundant Sebaceous Glands
Radix: Low to Normal
Nasal Bridge: Wide
Dorsum: Convex (Nasal Hump)
Tip: Bulbous, Thick-Skinned, Under-Projected, Occasionally Derotated to Normal, Abundant Nasal Soft Tissue, Broad Wide Domes, Minimal Definition
Columella: Short to Normal
Base: Wide, Thick, Horizontal & Flaring Nostrils
Nasolabial Junction: Retracted & Acute Nasolabial Angle
Maxilla: Within Normal Limits

Asian Nasal Anatomy
Skin: Heavy, Thick & Sebaceous
Radix: Deep & Flat
Nasal Bridge & Dorsum: Low, Wide & Flat
Tip: Bulbous, Thick-Skinned, Under-Projected, Ptotic, Abundant Fibrofatty Tissue, Broad Domes, Minimal Definition
Columella: Short, Minimal Show (Retracted)
Base: Wide, Thick, Oblique & Flaring Nostrils
Maxilla: Usually Retrusive

http://www.spaldingcosmeticsurgery.com

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