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Objectives: How to keep it simple and safe when starting out in rhinoplasty.
Having gone through the often painful process of 'learning as I go' when I first started performing rhinoplasties, I'd like to share what I think is a very safe distillation of the basics. I apply these simple steps in almost all my noses, and I think that by doinf the same, someone at the start of theor 'rhino journey' can make quicker progress to more advanced techniques, and avoid silly mistakes...

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Objectives: The aim of this paper is to address the question of the Rhinofiller as an effective alternative to rhinoplasty with a personal tecnique (LESS tecnique: Long term Efficacy, Safety, Stability tecnique)

Introduction: The LESS tecnique combines less trauma and oedema with long term efficacy, safety and stability.
Long term efficacy because of the utilization of a very high G prime specific hyaluronic acid.
Safety because of the exclusive use of a 25 Gauge cannula in 95% of cases (needle is just utilized for little intradermal adjustements or to push down the nostrils in the pinched nose defect) with only two access points.
Stability, because tip is always stabilized with columellar hyaluronic grafs, between and behind the medial crura, so botulinic toxin for depressor septum is never needed

Materials / method: we rewiewed 200 cases with a clinical follow up from 1 to 4 years. We found out new antropological measures, which can be used as indications of the tecnique choice (medical or surgical).

Results: The rhinofiller is comparable to surgical rhinoplasty in patients whose nasal radix height is less than 1,3 cm. Otherwise this tecnique seems to be less effective than surgery. The four year study with very high G prime hyaluronic acid allowed us to find stable and long lasting results. we found that also after some years corrections are not always necessary. A possible explanation is the biochemical composition of the tissue cartilages neighbourhoods. Furthermore, the scar tissue may favour the stability of the nonsurgical rhinoplasty result, if it is performed after a rhinoplasty.

Conclusion: This study allows us to find out some indications that make the non surgical rhinoplasty an effective alternative to surgical rhinoplasty

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Objectives: To identify a reliable, reproducible, clinically relevant classification that aids in the management of deviated nose rhinoplasty

Introduction: Deviated or crooked nose correction represents one of the hardest challenged in all of plastic surgery. The surgery often involves functional correction as well as cosmetic. While the term deviated is used as an umbrella term, this can include several varietes, each of which required to be tackled uniquely. While several classifications for deviated nose exist, many are complicated and do not correlate with the surgical manouvers required for their correction

Materials / method: Patient records were retrospectively for
1. Age, Sex
2. Technique used
3. Results
4. Patient satisfaction
All procedures were done with open rhinoplasty.

Results: Deviated noses where analysed in terms of deviations of shape (S) deviation of longitudinal axis(A), deviation of vertical tilt (T) also known as the SAT system. These were further prioritized in terms of the primary deformity and secondary deformities. Each of these components required unique surgical manoeuvres. These included spreader grafts, overlapping, caudal resection, bony excisions. Manoeuvres were classified as corrective and camouflage

Conclusion: Rhinoplasty is a fascinating surgery where multiple roads can lead to the same destination. Deviated noses represent a unique challenge in their complexity and variety. With our component based system, we hope to ease this difficult challenge

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Objectives: Majority of primary and secondary rhinoplasties are presently done by open approach. Bad scar on the columella might spoil the general impression after an otherwise excellent rhinoplasty. Objective with this presentation is to familiarize the audience with the better way to place incision, which will leave the columella intact
and will give the superior exposure of the anatomic structures of the nose tip.

Introduction: Several types of incision and division of columella are popular, all placed in the central segment of the columella. The aim of this article was to convey experience with columellar incision in the labio-columellar junction, which in author’s opinion results in better cosmesis and in an intact columella.

Materials / method: The review of 483 rhinoplasties performed during the four years 2018-2021 was undertaken. Labiocolumellar incision through the border of the two distinct aesthetic units the columella and the upper lip was chosen for all 140 patients operated by the open approach. Scars were evaluated with respect to visibility, color match and alinement to the surface of the surrounding skin, and were graded into three categories: excellent, good and poor. Skin and carnation type, depending on amount of melanin pigment in the skin, according to Fitzpatrick was determined for all patients. The correla

Results: Results Columellar scars could be evaluated in 94 patients who were seen ≥ 1
year after operation. The scar was excellent or practically invisible in 55 patients (59 %) and good or barely perceptible in 28 (30%). Poor or visible scars were seen in 11 patients (11%). Most of them were previously operated one or several times. Excellent and good scars were significantly more common than visible and bad scars (p < .001). The quality of the scar in the labio-columellar junction did not depend on, if patients had the lighter or darker skin. Both surgeon and the patients were satisfied.

Conclusion: Advantage of the incision in the labio-columellar junction was full exposure of the columellar anatomic structures, and better control and planning of the desired shape of columella. Junction incision results in less conspicuous scar, than incisions on the central segment of columella.LCI incision is the only rationale alternative if open rhinoplasty and an uppel lip lift by the bull horn incision are planned in the same session

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