The Problem Pinch deformity is one of the main sequelae of routine reductive rhinoplasty. Although the prevailing trend is to preserve the nasal cartilages as much as possible, pinch deformity is still quite common. Several primary rhinoplasty patients show some…
Alar pinch deformity (APD) is the concave deformity of the tip area or nose alar that makes a change in the shape of the tip or causes buckling in on one or both sides. It may occur with or without…
The Problem Vascular compromise after surgical rhinoplasty is a rare but devastating complication that can lead to negative functional and aesthetic outcomes. Proper pre- and postoperative evaluation and management is critical, and include patient selection, limiting pre- and intraoperative risk…
The Problem How to make simultaneous orthognathic and rhinoplasty surgery predictable. The Background Orthognathic surgery and rhinoplasty are both challenging procedures, each requires a lot of experience, skill, and knowledge such as having the clinical judgment to determine when to…
Introduction Cleft lip and palate (CLP) is the second most common congenital defect in the United States—affecting approximately 7,000 infants annually. CLP is caused by a variety of environmental and genetic factors. Due to hypoplastic or absent tissues, as well…
The Problem Aging causes tremendous effects on skin and underlying structures of the nose. These changes may lead to nasal airway incompetencies and cosmetic deformities. Rhinoplasty in this group of patients needs specific evaluations and precise technique. The Background Age-related…
The Problem The predominant characteristics in thick-skinned patients seeking rhinoplasty are a bulbous nasal tip, poor definition of the different nasal subunits, and persistence of postoperative swelling if compared with normal- or thin-skinned patients, leading to inferior esthetic outcomes. The…
Introduction Almost every osseocartilaginous vault is asymmetric. This emphasizes the importance of individualized osteotomy when performing rhinoplasty. Specific anatomical variations in the bony vault such as width, length and height should be considered when selecting specific osteotomies. Osteotomies should no…
The Problem The mixed race nose, also called mestizo nose or Hispanic nose, is a term that refers to nasal characteristics that include thick skin, a bulbous tip, and weak and flimsy cartilaginous structure. Patients frequently exhibit Fitzpatrick skin types…
The Problem Massive immigration started in the colonial period and a consequent high degree of miscegenation made rhinoplasty in the Brazilian population a challenge that requires handling and mastering different techniques. Due to the racial mixture, patients of predominantly White…