Abstract

Objectives: Goal and objectives: • systematization and classification deformity of the nose • development and implementation of complex correction algorithms that take into account the prevailing factor in the occurrence of this manifestation; • the study of the optimal combination of treatments for their synergistic effects; • injection rhinoplasty with HA-fillers and PDO threads as part of a comprehensive program of beautification of the middle third; • concept of remodeling the shape of the nose depending on the degree of trauma or other factors such as precocious rhinoplasty ,belonging to a morphotype; • clinical testing of new techniques to demonstrate well-proven quality and safe medicine for injectable correction the shape of the nose • use combine method PDO threads with a ha-fillers Introduction: Introductions. The non surgical Rhinoplasty is one of the most recommended and affective procedures for ingactible aesthethic corrections. Non surgical rhinoplasty reserved correction of the post-surjical impertections such as camouflage after surgical rhinoplasty after trauma or for improving the shape of the nose. With combining some fillers and PDO collagen stimulated threads we are able to do this by placing smooth and barbed threads . The best benefits of this techniqui are that you can get safe and easy results. Materials / method: Main part. Of cours the most important thins is knowleges of anatomy of the nose. We have to remember ,that the dorsal nasal artery runs alon the dorsum of the nose,that is approximately 3 mm away from the midline of the nose .It is a very significant vessel that gives blood suppluy to the surrounding tissue ,the needle can be inserted parallel into that blood vessel. The dorsal nasal artery anastomoses with the ophthalmic,intratrochlear and agular arteries.The widespread embolism through the connected blood vessels manifists as skin necrosis in geographic pattern . It is also a branch of ophthalmic artery so we should remember that propagation of the fillers embolus may cause eye symptoms. The nasal tip area is supplied primarily by the angular and the superior labial arteries,which are derived from the facial artery. In general,the angular artery,provides the lateral nasal artery,wich passes medially along the cephalic margin of the Lateral crura and gives off caudal branches toward the nostril rim. The superior labial artery originates from the columella to the region between the domes. The lateral nasal and columellar arteries then meet over the dorsal region,forming an alar arcade that runs along the cephalic margin of the lateral crura.This arcade runs superficial to the SMAS. Superficial to the alar arcade is the subdermal plexus of the nasaltip skin that is supplied by branches of bouth ophthalmic and facial artery system. Venous system also runs superficial to the SMAS along the lateral wall,dorsum,and supratip regions of the nose. One of the most important viens in the nose is the lateral nasal vein ,which runs over the perichondrium of the middle nasal vault . Analyzing the Nose: Nasal fillers and threads indications: -want to wear thear Rhinoplasty -bridge to thear secondary or tertiary Rhinoplasty -can’t afford Rhinoplasty -don’t desire nasal surgery -should’t have any more nasal surgery 3)Method of procedures: With HA fillers we can be able to use for dorsume with a 90-degree inclination to minimize the subdermal course of the needle, thus reducing the risk for vessel incannulation. The beveling of the needle is oriented toward the finger compressing the dorsum. The medial dorsum is slightly overcorrected, whereas injection is more conservative laterally. The injected area is gently massaged to avoid bumps. For incriase nasal projection the needle is inserted with a 45-degree inclination addressing the inferior border of the nasal spine. Injection should start submuscularly with the needle touching the nasal spine. Besides providing tip support, the submuscular injection also lengthens the depressor septi muscle, thus reducing its retracting effect on the tip. PDO threads have been used for nasal tip projection, dorsal length elongation, and nostril correction. The results of relative length ratios comparing true lateral photographs showed significant increase in tip projection. Results: Goal and objectives: • systematization and classification deformity of the nose • development and implementation of complex correction algorithms that take into account the prevailing factor in the occurrence of this manifestation; • the study of the optimal combination of treatments for their synergistic effects; • injection rhinoplasty with HA-fillers and PDO threads as part of a comprehensive program of beautification of the middle third; • concept of remodeling the shape of the nose depending on the degree of trauma or other factors such as previsoious rhinoplasty ,belonging to a morphotype; • clinical testing of new techniques to demonstrate well-proven quality and safe medicine for injectable correction the shape of the nose • use combine method PDO threads with a ha-fillers Conclusion: Conclusions : The nonsurgical rhinoplasty technique with HA-Fillers and PDO threads described here proved to be safe, effective, and reliable with excellent patient-reported outcome. It may allow correction of selected nasal defects with reduced cost and minimal downtime