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IMCAS World Congress 2020
Program

FOCUS ON S078

Long & short nose

Room: Room 342 - level 3
Date: Thursday 30 January 2020 at 15:00 to 16:00
Format: FOCUS SESSION > lectures covering a major topic of the congress

Chairs

Dr Olivier GERBAULT

Plastic Surgeon

France

Dr Alexandra MORA HERNANDEZ

Facial Plastic Surgeon

Colombia

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
15:00	Dr Luiz Carlos ISHIDA	Partially split septal cartilage for septal extension graft: pearls and pitfalls	View	97835
15:10	Dr Pietro PALMA	Shortening long noses made easy	View	98360
15:20	Dr Yu Hsun CHIU	Short nose rhinoplasty		98361
15:30	Dr Jay CALVERT	Lengthening the short nose	View	98359
15:40	Dr Ramon VILA ROVIRA	Dorsal-domal discrepancy in rhinoplasty	View	99663
15:50		Q&A		99664

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Nose (rhinoplasty - surgical)

Nose (non-surgical)

Dr Luiz Carlos ISHIDA

Plastic Surgeon

Brazil

Other author(s) :

Partially split septal cartilage for septal extension graft: pearls and pitfalls

Objectives: The objective of this presentation is to present an alternative to the septal extension graft.

Introduction: Septal extension grafts are very useful when dealing with short noses or under projected tips. They provide the structural support to anchor the tip in the new position. The problem resides that it might create a excessive asymmetric bulk in one airway.The partially split septal cartilage is less obstructive in the airways and allows fine tuning of the septal extension angle.

Materials / method: The partially split septal cartilage is used instead of a septal extension graft and allows the fine tuning of the caudal portion. A fragment of about 1,5 X 1,5 cm is taken from the cartilaginous septum. Under magnification this cartilage is splited halfway its length. The spited leafs are attached to the remaining septum one leaf each side.

Results: to be shown

Conclusion: The partially split septal cartilage is used instead of a septal extension graft and allows the fine tuning of the caudal portion. It also minimizes the bulk in the airway path.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Pietro PALMA

Facial Plastic Surgeon

Italy

Other author(s) : Irina Vasilenko, MD, PhD

Shortening long noses made easy

Objectives: Selecting the best combination of surgical techniques to shorten unoperated long noses.

Introduction: Nose shortening represents one of the most common procedures in Caucasian rhinoplasty patients.
Basically, there are six structures playing a key role in determining an excessive nasal length: the septal cartilage, size and configuration of the lower lateral cartilages (LLC), the cephalo-caudal extension of the upper lateral cartilages (ULC), the ligamentous structures connecting the tip cartilages to the cartilaginous mid-nose, the skin-soft tissue envelope, and length-laxity of the internal lining.

Materials / method: 25 primary consecutive septo-rhinoplasty patients (14 females, 11 males) were enrolled into the study, each one having an obvious imbalance of the radix:infratip distance. All the procedures were performed via an endonasal (closed) approach under general anaesthesia. All patients underwent a custom-made combination of different surgical procedures. The mean follow-up was 18.3 months. The aesthetical result was evaluated by comparing standard pre- and post-operative views (frontal and side views).
Independent evaluators were asked for aesthetic evaluation of the final outcome.

Results: Independent evaluators concluded that achievement was achieved in all patients, consistent with patients’ self-assessment. No complication were recorded in any patient during the follow up-period. 3 patients had touch-up surgery due to mild tip ptosis, columellar hanging and partial caudal septum deflection.

Conclusion: Excessive nasal length can be successfully corrected by a tailor-made combination of surgical manoeuvers aimed to reduce the cephalic-caudal vector of the cartilaginous nasal framework and to adapt both the overlying the skin-soft tissue envelope and the inner lining to the newly reshaped skeleton. Stabilizing sutures and domal tip grafts do greatly contribute to the aesthetic quality of the final outcome.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Yu Hsun CHIU

Facial Plastic Surgeon

Taiwan

Other author(s) : no

Short nose rhinoplasty

Objectives: ■ Lenging a short nose is a challenging rhinoplasty problem.
- Anatomy
- Analysis

■ The surgical approach depends mostly on the quality of
the lining, skeleton, overlying skin, & the amount of correction desired.
- Lengthening the central compartment
- Correction of the lateral compartment
- Dorsal augmentation
- Nasal tip surgery

■ The lengthened nose lost much of its intraoperative length because the con-traction process of the soft tissues simply pulled the nose back
towards its original length !!

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Jay CALVERT

Plastic Surgeon

United States

Other author(s) :

Lengthening the short nose

Objectives: 1. Understand why a short nose is not desirable
2. Review the methods for lengthening the short nose
3. become familiar with the size of nose that will not overwhelm the face and make the patient look better.

Introduction: Lengthening the short nose is not an easy task. The first step to successful lengthening is to be able to analyze the nose and understand why the nose is short. Through detailed analysis and planning, the reasons why a nose is short can be discovered and the plan to improve the situation will show themselves.

Materials / method: Case analysis methods were used to review multiple cases and discover why the nose was short. Then, the methods of lengthening were selected based on the problems.

Results: Analysis of the selected cases was performed. The methods of lengthening were chosen and executed accordingly.

Conclusion: Lengthening the short nose can be performed effectively. Analysis and planning are the keys to success.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Ramon VILA ROVIRA

Plastic Surgeon

Spain

Other author(s) :

Dorsal-domal discrepancy in rhinoplasty

Objectives: There are subjective and important evaluation tools obtained through experience, such as the vision of harmony and the aesthetic proportions of each element in the nasal structure and it is essential for the analysis of the immediate postoperative result, evaluating part of the structural and aesthetic changes achieved with the surgical procedure and if these meet the expectations of the surgeon and patient raised before surgery.

Introduction: Rhinoplasty is a surgical procedure of restructuring the nasal architecture with an artistic touch, the vision of the nasal profile and the proportions that the structures keep is fundamental for the correct evaluation of the result.

Materials / method: In the nasal profile view the main elements that are taken into account are: radix, the bony and cartilaginous dorsum line, the lower lateral cartilages and their maximum projection point (domes), and the columella. Likewise, the relationship keeps the nose with the facial structures and the facial plane (rotation and projection).

Results: Dorso-Domal Discrepancy (DDD) is defined as the difference between the height of the lowest point of the dorsum line (dorsum-tip transition point) and the point of maximum projection of the nasal tip at the level of the domes, from a side view of the nasal pyramid, expressed in millimeters.

Conclusion: A D.D.D. between 5 and 10 mm a nasal profile with a harmonic and aesthetic appearance is considered, one of the objectives of rhinoplasty is to achieve these proportions between the dorsum and the nasal tip. This discrepancy is also variable and changes with each type of nose in which the back and the tip have defined characteristics such as racial diversity, for example caucasian, asian, ethnic noses, etc.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

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IMCAS World Congress 2020 Program

FOCUS ON S078

Long & short nose

Chairs

Lectures of the session

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IMCAS World Congress 2020
Program