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IMCAS World Congress 2024
Program

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FOCUS ON 065

Rhinoplasty - Contributed talks

Room: Room 341 - Level 3
Date: Thursday 1 February 2024 at 17:00 to 18:00
Format: CONTRIBUTED TALKS > session made up of abstract submissions that were carefully reviewed and selected by the Scientific Board

Chairs

Dr Igor NIECZAJEW HANSON

Plastic Surgeon

Sweden

Dr Aniketh VENKATARAM

Plastic Surgeon

India

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
17:00	Dr Yasser ELSAYED ELBADAWY	Structural preservation tip rhinoplasty in thick skin noses: hybrid technique	View	130820
17:08	Dr Hwan Jun CHOI	Real-time ultrasonography-guided closed reduction of nasal bone fracture in patients with nasal implant	View	130821
17:16	Dr Kurdo QARADAXI	Balancing form and function: spreader grafts for crooked nose correction with dorsum preservation	View	130822
17:24	Dr Alberto DIASPRO	The "Rhino-Lip-Lifting": a novel proposal for midface profiloplasty performed as a single surgical procedure	View	130823
17:32	Dr Levi John LANSANGAN	Nasal elevation, life transformation: the combined use of irradiated rib and dermis for augmentation rhinoplasty among Asian noses	View	130824
17:40	Dr Hossein ABDALI	Percutaneous, subcutaneous alar rim graft: new technique	View	135117
17:48		Q&A		130825

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Recommended sessions

Nose (rhinoplasty - surgical)

Lips (surgical)

Ultrasonography

Dr Yasser ELSAYED ELBADAWY

Plastic Surgeon

Egypt

Other author(s) :

Structural preservation tip rhinoplasty in thick skin noses: hybrid technique

Objectives: Rhinoplasty in thick skin patients could be very challenging. Difficult skin re draping, lax and weak ligaments, thin and flimsy cartilage all are contributing factors to failure of distinction between the different subunits of the nose.

Introduction: Most of the soft tissue relationships and many of the structural components contributing to the support of the nasal tip are disrupted during an open approach specially Pitanguy and scroll ligaments. Also, the strength of weak cartilage in thick skin nose becomes more week by surgical manipulation. Aim of this study is to asses the long term outcomes of rhinoplasty with both tip structure and ligaments preservation.

Materials / method: 43 patients underwent open rhinoplasty with ligaments preservation and tip structure technique considering nasal base stabilization with septal extension graft and other tip grafts.

Results: All patients have better aesthetic and functional outcome with long lasting definition, projection and rotation.

Conclusion: refinements of nasal surgery have no limits. Study suggests that structural nasal tip with ligaments preservation could maintain nasal tip definition, projection, and rotation.

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 Hwan Jun CHOI

Plastic Surgeon

South Korea

Other author(s) :

Real-time ultrasonography-guided closed reduction of nasal bone fracture in patients with nasal implant

Objectives: The aim of this study is to evaluate the usefulness of intraoperative real-time ultrasonography for the management of nasal bone fracture in those patients.

Introduction: The frequency of nasal bone fractures is increasing among patients with nasal implant. The aim of this study is to evaluate the usefulness of intraoperative
real-time ultrasonography for the management of nasal bone fracture in those patients.

Materials / method: During 4 years, we studied 15 patients diagnosed with nasal bone fracture who had undergone augmentation rhinoplasty with silicone implant. Preoperative nasal lateral view, skull waters’ view, and facial bone 3-dimensional computed tomography were performed. During surgery, a 12-5-MHz linear-array probe which provides axial and sagittal views was used to check the bony fragments, alignment, and implant shift in real time. To evaluate the surgical outcomes, patients were classified into three groups: excellent, good, and poor group.

Results: Patients include 4 males and 11 females aged 21-40 years. Clinical symptoms were pain, swelling, nasal bleeding, and nasal deformity. There were two cases of implant shift. After surgery, all patients showed stabilization of bony alignment on postoperative plain radiograph. 11 patients and 4 patients were classified as excellent and good group respectively. There was no case of poor group requiring revision surgery.

Conclusion: Intraoperative real-time ultrasonography attributes to a safe and accurate reduction providing anatomical location of implant and bony fragments in patients with nasal implant.

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 Kurdo QARADAXI

Plastic Surgeon

Iraq

Other author(s) :

Balancing form and function: spreader grafts for crooked nose correction with dorsum preservation

Objectives: 1-Understand the challenges and complexities of crooked nose correction.
2-Explore the principles and techniques of using spreader grafts for nasal dorsum preservation.
3-Learn about the aesthetic and functional benefits of this approach.
4-Analyze the outcomes and success rates of crooked nose correction with spreader grafts and dorsal preservation.

Introduction: Crooked noses present both aesthetic and functional challenges to patients. Achieving a harmonious and functional result is the primary goal of rhinoplasty surgeons. This presentation aims to shed light on the technique of using spreader grafts for crooked nose correction while preserving the nasal dorsum. By maintaining the nasal dorsum's structural integrity, we can achieve a balanced and natural appearance, ensuring both form and function are optimized.

Materials / method: INCLUSION CRITERIA:
Patient Selection: Discuss the criteria for selecting suitable candidates for this procedure.
Surgical Technique: Describe in detail the steps involved in using spreader grafts and preserving the nasal dorsum.
Case Studies: Present a series of case studies with pre-operative and post-operative photos.
Complications and Mitigations: Address potential complications and how to manage them

Results: The aesthetic and functional results of the insertion of the submucosal spreader graft beneath the subdorsal spetum were analyzed. Patient satisfaction was measured
using validated outcome instruments and patient-reported outcome measurements (SCHNOS). Statistical analysis was
conducted to compare the outcomes of the techniques.

Conclusion: In conclusion, the utilization of spreader grafts with dorsal preservation in crooked nose correction offers a promising approach that balances both form and function. This technique allows for the achievement of a natural and harmonious nasal appearance while ensuring optimal nasal airflow and function. Through the presentation of case studies and results, we have demonstrated the effectiveness and patient satisfaction associated with this method. Rhinoplasty surgeons can consider this approach as a valuable tool in their armamentarium for addressing crooked noses

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 Alberto DIASPRO

Facial Plastic Surgeon

Italy

Other author(s) : Gloria Marchese, Michele Pascali

The "Rhino-Lip-Lifting": a novel proposal for midface profiloplasty performed as a single surgical procedure

Objectives: Tip rotation to a normal nasolabial angle width itmay not fully balance the midface profile as it is the “lip position-to-incisal show” ratio that defines beauty, whereas the balance among forehead, nasal tip, upper lip, and chin is what defines the contour of harmonious profiles.

Introduction: As facial aging occurs, aesthetic changes of the nasal tip and the senile upper lip include tip ptosis, increase in skin length, loss of vermillion height and Cupid’sbow,and vertical wrinkles.
Regardless of the rejuvenation procedure, the lips are not to be considered as a single anatomical entity, instead they should be placed in a strong correlation with the nose.
The aim of this study is therefore to demonstrate the effectiveness of the association of primary closed rhinoplasty together with indirect subnasal lip-lifting technique.

Materials / method: A total of 45 patients were enrolled in this study and underwent primary closed
rhinoplasty with indirect subnasal lip-lifting.

Results: The result showed an overall average
nasolabial angle width reduction of 10.9% and lip length shortening of 23.5%, as
assessed 1 year after the surgical procedure. When comparing before and after
photographs and using the Subjective Global Aesthetic Improvement Scale (sGAIS), the overall satisfaction was rated 4.4 on 5, as “much improved.”

Conclusion: The authors show that lips should not be considered as a single anatomical entity but that they indeed must be placed in a strong correlation with the nose since a droopy nasal tip is likely to be considered unattractive and is often associated with the appearance of a long nose with covered philtrum and upper lip.
This is the first patient series to show that the combination of closed rhinoplasty and indirect lip-lifting is a highly effective, safe, and reliable procedure to address profile rejuvenation.

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 Levi John LANSANGAN

Facial Plastic Surgeon

Philippines

Other author(s) :

Nasal elevation, life transformation: the combined use of irradiated rib and dermis for augmentation rhinoplasty among Asian noses

Objectives: The gold standard for augmentation rhinoplasty is the harvest of rib cartilage for bridge elevation as well as nasal tip definition. Autologous rib cartilage is the only biocompatible material that is readily available and abundant in the body. However not all patients wants a secondary chest scar as well as the added morbidity resulting from the rib cartilage harvest. The author's objective is to provide an alternative surgical procedure that is safe, worry free, natural looking with the same complication rate as that of autologous rib rhinoplasty.

Introduction: Rhinoplasty is cosmetic surgery that is performed to reshape the nose. The use of grafts, such as rib cartilage, is a common part of rhinoplasty when significant structural changes are needed or when significant amounts of additional material are needed to achieve the desired results.
Irradiated rib cartilage is one of the types of graft material that can be used in rhinoplasty. It's harvested from a donor, sterilized with radiation to kill any potential diseases or pathogens, and then used in other patients.

Materials / method: A total of 121 patients who complained of low nasal dorsum and weak tip support underwent open structural rhinoplasty using the irradiated rib as a saddle graft anchored on the caudal portion of the quadrangular (septal) cartilage. PDS 5-0 suture was used to stabilize the graft in 3 points to prevent collapse, dislocation or derotation of the irradiated rib. The irradiated dermis on the other hand was placed on the nasal dorsum and was carved according the desired nasal height and width of the patient.

Results: More than 92% of the patients were satisfied with the results of the surgery. There were 4 cases of nasal tip deviation, 4 cases of asymmetric nostrils, 1 case of nasal tip show. Patients’ satisfaction was graded as 1. Very satisfied 2. Satisfied 3. No change 4. Dissatisfied 5. Very dissatisfied. More than 90% were very satisfied, 2% satisfied and 8% unsatisfied.

Conclusion: Conclusion: the use of irradiated rib is a superior material that can be used for nasal tip definition and nasal elongation without the need to harvest the septal cartilage or rib cartilage. Due to the relative weakness of the septal cartilage of the Asian noses, the use of the irradiated rib can provide good tip support especially when anchored with the caudal portion of the quadrangular cartilage properly. In addition, there is no need to prolong the surgery and harvest patients own rib cartilage and thus preventing a secondary chest scar and added morbidity from the harvest.

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 Hossein ABDALI

Plastic Surgeon

Iran

Other author(s) :

Percutaneous, subcutaneous alar rim graft: new technique

Objectives: Alar rim as functionally and aesthetically is one of the most important subunits of the nose, which is mainly formed by lower lateral cartilage. In the field of aesthetics, the configuration of the alar rims on both sides is important in the placement of the nose tip and on the other hand in such a way any regularity is always visible. The proper appearance of the rim includes regular contours, well-defined margins, and a normal relationship with the columella. Alar rim reconstruction for correction of irregularities and asymmetries is one of the most important aims of rhinoplasty.

Introduction: several methods have been introduced which their efficiency and indication of these methods is different and it can still be more ideas for introducing new techniques .

Materials / method: During open rhinoplasty at the end of operation and suture step or inverted V incision on columella and before complete close mucosal layer , a piece of cartilage with average size 10x4x2 mm placed subcutaneously in space of previously dissected for skeletonization of nose and fixed transcutaneously with a 0-6 non-absorbable suture ( Prolene ) and remove two week after operation .

Results: : Patients was evaluated after two weeks, one month and six months and one year after operation and alar rim evaluated according to the Gunter classification and Guyuron classification and result was good and acceptable

Conclusion: alar rim reshaping with this technique is simple and without any complication and with long term good result suggested in routine rhinoplasty which need more cartilage reshape and support

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 2024 Program

FOCUS ON 065

Rhinoplasty - Contributed talks

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2024
Program