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Wang G, Wei M, Zhen Y, Li D, An Y. Three-Dimensional Morphological Study on the Effectiveness of Expanded Polytetrafluoroethylene Prosthesis in the Paranasal Augmentation. Aesthetic Plast Surg 2024; 48:398-406. [PMID: 38133836 DOI: 10.1007/s00266-023-03755-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The paranasal depression is a common facial feature of Oriental populations. One of the most wildly used method to improve it was paranasal augmentation using expanded polytetrafluoroethylene (ePTFE). The effectiveness of it should be tested by three-dimensional morphological measurements. METHODS Patients who underwent paranasal augmentation using ePTFE between January 2017 and December 2022 were recruited in the study. The preoperative and postoperative clinical variables and three-dimensional measurement of patients were also collected. The satisfaction outcome were assessed. RESULTS By establishing a coordinate system based on the Frankfurt plane, 16 landmarks including nasal alar crest, subnasal point, upper lip, pogonion, glabella, sub-cheek, orbitale, tragion in left and right side of faces were marked. Five segments, 4 ratios, and 3 angles were measured based on it. The significant increase of segments, ratios, and angles indicated that paranasal augmentation could increase the protrusion of paranasal area, both in absolute value and relative proportion. The significant decrease of other data indicated that the protrusion difference between paranasal base and upper lip, forehead, and chin, respectively, were shortened after surgery. The average size of implant was 6.54 ± 1.02 mm, and the average increase of paranasal height was 4.38 ± 1.04 mm postoperatively. This indicates that two-thirds of its height will ultimately be reflected effectively in the sagittal elevation of the paranasal base. CONCLUSIONS Paranasal augmentation using ePTFE could effectively increase paranasal height and improve subunits relationships, and the ePTFE prosthesis should be designed and carve considering the 1/3 loss of height after implantation. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Guanhuier Wang
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Muqian Wei
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Dong Li
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yang An
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
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An Y, Shu F, Xie L, Zhen Y, Li X, Li Y. Use of nasal septal bone to straighten septal L-Strut in correction of east Asian short nose: A retrospective study. J Cosmet Dermatol 2023; 22:1825-1834. [PMID: 36718843 DOI: 10.1111/jocd.15643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/13/2022] [Accepted: 01/08/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND The perpendicular plate of ethmoid (PPE) was used to correct short noses in rhinoplasty in Asians, but the safe harvest of the plate and the assessment of its clinical application has been perplexing to plastic surgeons. AIMS To explore how to safely cut the perpendicular plate of ethmoid bone and evaluate its application effect. PATIENTS/METHODS A finite element model was established to guide the clinical operation. A total of 30 patients with short noses were selected. Among them, 15 patients used autologous septal cartilage to lengthen the nasal tip, and 15 patients used the PPE to strengthen the L-shape nasal septum. The differences in the esthetic parameters of the nose, complications, and patients' satisfaction were compared between the two groups. RESULTS Significant differences were noted in the nasal dorsal length (p = 0.001), Goode's ratio (p = 0.001), and nasofrontal angle (p = 0.003) after rhinoplasty, and no significant differences were noted in any of the esthetic parameters between the two groups. The symptoms of nasal obstruction in the experimental group were significantly lighter than those in the control group (p = 0.04). There was no statistically significant difference in the doctors' assessment of outcomes between the two groups (p = 0.48). CONCLUSION The safest region to harvest the PPE is in the middle and lower third. Rhinoplasty improves the esthetics of the patient's nose. The PPE used to strengthen the L-shape nasal septum structure has a smaller probability of nasal septal deviation with the time in Asian short noses.
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Affiliation(s)
- Yang An
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Fan Shu
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Lifeng Xie
- Department of Otorhinolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Xiao Li
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Yixin Li
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
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An Y, Wang G, Li X, Zhen Y, Zhao J, Li D. Rhinoplasty with Simultaneous Autologous Full-Face Fat Transfer for Asian Facial Contouring Balance: A Retrospective Study. Aesthetic Plast Surg 2022; 47:746-756. [PMID: 36042025 DOI: 10.1007/s00266-022-03064-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aesthetic facial contouring procedures have gained an increasing popularity in the Asian population. Nevertheless, currently, there are few specific literature assessments and studies on the outcomes of rhinoplasty combined with full-face fat graft contouring. To conduct an objective evaluation of the efficacy of Asian rhinoplasty combined with autologous facial fat transfer in terms of 3-dimensional measurement and patient-reported outcomes. METHODS Patients who underwent rhinoplasty combined with full-face fat transfer for facial contouring between January 2016 and July 2019 were recruited in the study. The preoperative and postoperative clinical variables and 3-dimensional measurement of patients were also collected. The satisfaction outcome of surgeons and patients was assessed. RESULTS Twenty patients completed rhinoplasty with full-face fat transfer. The average postoperative follow-up was 10.2 months (range 6-24 months). The nasal length, and the nasal protrusion rate were significantly increased (p < 0.05) after surgery, and the median number of nasolabial angles decreased from 106° to 101°, which was closer to the aesthetic standard of 90°-100°. The topographical projection images of whole face indicated that the volume of frontal, temporal, inner cheek and chin regions were increased obviously. All cases received satisfaction outcome based on surgeons' satisfaction scale, ROE scale, FACE-Q overall facial satisfaction scale, and FACE-Q Rhinoplasty scale. Additionally, no patients had intraoperative or postoperative complications. CONCLUSIONS Rhinoplasty combined with full-face fat transfer is a reliable and effective method of augmenting and contouring the facial convexity in the Asian populations. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yang An
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
| | - Guanhuier Wang
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Xiao Li
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Jianfang Zhao
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Dong Li
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
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Heiman AJ, Nair L, Kanth A, Baltodano P, Patel A, Ricci JA. Defining regional variation in nasal anatomy to guide ethnic rhinoplasty: A systematic review. J Plast Reconstr Aesthet Surg 2022; 75:2784-2795. [PMID: 35725958 DOI: 10.1016/j.bjps.2022.04.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recently, there has been increasing focus on understanding nasal anatomy in ethnic populations and using it to guide rhinoplasty techniques in non-Caucasian patients. Many disparate groups have historically been inappropriately clustered based on geography. However, there has been little attention on describing regional differences within these populations. METHODS A systematic review was conducted according to PRISMA guidelines. The search terms "African", "Asian", "Indian", "Middle Eastern", "Hispanic OR Mestizo", "rhinoplasty", "nasal", "anatomy", and "ethnic" were used in combination with the Boolean operators "AND" or "OR" to identify the initial search results. Papers were included if they originated from the specific geographic region of interest, if they specifically discussed patients of one particular nationality or sub-ethnicity, or if they discussed multiple anatomical subtypes within a specific ethnicity of interest. RESULTS A total of 81 papers were identified overall. The search identified 40 articles discussing Asian nasal anatomy, 8 articles discussing Indian nasal anatomy, 6 articles discussing African nasal anatomy, 9 articles discussing Middle Eastern nasal anatomy, and 19 papers discussing Latin American nasal anatomy. Numerous regional variants were described within each historic geographic phenotype. The majority of descriptions of Asian nasal anatomy were consistent with the classical definition, whereas nasal anatomy among the other ethnicities was more variable. Very little has been written about the geographic variation of nasal anatomy across the African continent. Several established sub-classification schemes exist for the Latin American nose. CONCLUSIONS Awareness of the heterogeneity of ethnic nasal anatomy is critical for surgeons performing rhinoplasty on non-Caucasian patients.
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Affiliation(s)
- Adee J Heiman
- The Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, United States
| | - Lakshmi Nair
- The Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, United States
| | - Aditi Kanth
- The Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, United States
| | - Pablo Baltodano
- The Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, United States
| | - Ashit Patel
- The Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, United States
| | - Joseph A Ricci
- The Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center, 1776 Eastchester Road, Suite 200, Second Floor, Bronx, NY 10461, United States.
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Katsube M, Yamada S, Miyazaki R, Yamaguchi Y, Makishima H, Takakuwa T, Yamamoto A, Fujii Y, Morimoto N, Ito T, Imai H, Suzuki S. Quantitation of nasal development in the early prenatal period using geometric morphometrics and MRI: a new insight into the critical period of Binder phenotype. Prenat Diagn 2017; 37:907-915. [PMID: 28675493 DOI: 10.1002/pd.5106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/02/2017] [Accepted: 06/29/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Disturbance of the development of the nasal septum in the early prenatal period causes congenital facial anomalies characterized by a flat nose and defects of the anterior nasal spine (ANS), such as Binder phenotype. The present research aimed to assess the development of the nasal septum and the ANS with growth in the early prenatal period. METHODS Magnetic resonance images were obtained from 56 specimens. Mid-sagittal images were analyzed by using geometric morphometrics for the development of the nasal septum, and angle analysis was performed for the development of the ANS. Additionally, we calculated and visualized the ontogenetic allometry of the nasal septum. RESULTS Our results showed that the nasal septum changed shape in the anteroposterior direction in smaller specimens, while it maintained an almost isometric shape in larger specimens. Furthermore, mathematical evidence revealed that the maturation periods of the shapes of the ANS and the nasal septum were around 12 and 14 weeks of gestation, respectively. CONCLUSION The anteroposterior development of the nasal septum is specific until 14 weeks of gestation, and it is important for nasal protrusion and the development of the ANS. Therefore, the disturbance of such development could induce low nasal deformity, including Binder phenotype. © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Motoki Katsube
- Department of Plastic and Reconstructive Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Congenital Anomaly Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shigehito Yamada
- Congenital Anomaly Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Reina Miyazaki
- Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yutaka Yamaguchi
- Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Haruyuki Makishima
- Congenital Anomaly Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tetsuya Takakuwa
- Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akira Yamamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yosuke Fujii
- Statistical Genetics, Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoki Morimoto
- Department of Zoology, Kyoto University Graduate School of Science, Kyoto, Japan
| | - Tsuyoshi Ito
- Primate Research Institute, Kyoto University, Aichi, Japan.,The Keihanshin Consortium for Fostering the Next Generation of Global Leaders in Research (K-CONNEX), Kyoto, Japan
| | - Hirohiko Imai
- Department of Systems Science, Kyoto University Graduate School of Informatics, Kyoto, Japan
| | - Shigehiko Suzuki
- Department of Plastic and Reconstructive Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Oriental nose occidentalization and perinasal shaping by augmentation of the underdeveloped anterior nasal spine. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2014; 2:e197. [PMID: 25426380 PMCID: PMC4236358 DOI: 10.1097/gox.0000000000000161] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 06/25/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Augmentation of an underdeveloped anterior nasal spine (ANS) occidentalizes the Oriental nasal shape. The objective of this study was to investigate the effect of ANS augmentation using an injectable filler, assessing volumetric changes with 3-dimensional images and measuring 2-dimensional images. METHODS Forty Japanese patients were treated and evaluated before and after the augmentation. Local anesthetic was injected on the ANS for analgesia. To augment the underdeveloped ANS, approximately 0.5-1.0 ml of calcium hydroxylapatite filler was injected between the medial crura footplates and the ANS. Two-dimensional measurements and superimposable 3-dimensional volumetric assessments were performed pretreatment and 7 days posttreatment. Patients rated their satisfaction using a 5-point scale. RESULTS A significant decrease in nasal width and nostril axis inclination and an increase in nasal tip projection and columellolabial angle were observed by 2-dimensional measurements. Superimposable 3-dimensional color images reinforced the results of the 2-dimensional measurements and showed volumetric soft-tissue changes in the nasal and perinasal areas and the lower cheeks. Ninety percent of the patients were either "satisfied" or "very satisfied" with the results. Posttreatment traction pain and edema resolved in 5 days. Side effects such as hematoma, nodules, and skin necrosis were not observed. CONCLUSIONS Objective assessments showed significant effects of this treatment, with good patient satisfaction and minimal levels of discomfort and side effects. Together these results demonstrate that this treatment is safe and effective for Oriental nose occidentalization and perinasal shaping and is also useful for predicting rhinoplasty results.
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Cho YS, Hwang KG, Park CJ. Postoperative effects of anterior nasal spine bone harvesting on overall nasal shape. Clin Oral Implants Res 2012; 24:618-22. [PMID: 22335397 DOI: 10.1111/j.1600-0501.2012.02428.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2012] [Indexed: 11/27/2022]
Abstract
AIM Bone harvesting from the anterior nasal spine (ANS) is frequently used to correct peri-implant bone defects, particularly during implant placement in the anterior maxilla. However, many clinicians are concerned about the postoperative effect of removing the ANS on the nasal outline, as the ANS is integral to supporting the nose. This study aimed to describe the technique of ANS bone grafting and to investigate postoperative effects of bone harvesting from the ANS on the overall nasal shape. MATERIAL AND METHODS Fifteen patients with single maxillary first incisal rehabilitation using dental implant were enrolled in this prospective clinical study. Simply by extending the subperiosteal dissection in the same surgical field without additional local anesthesia, a bone block of about 0.25-0.5 ml could be harvested from the ANS. Nose width (NW), nasolabial angle (NLA), and nasal tip depth (NTD) were measured and analyzed by lateral and frontal photographs taken preoperatively (T0), and at postoperative 1 week (T1), 3 months (T2), and 6 months (T3). Postoperative complications were also recorded. RESULTS A significant increase in NW and decrease in both NLA and NTD were found at T1 (P < 0.05). At T3, NW, NLA and NTD returned to preoperative measurements at T0 without major complications. CONCLUSIONS The ANS could be an effective and easily accessible intraoral source for autologous bone. Despite acute soft tissue swelling, the net postoperative effects of removing the ANS on the overall nasal shape, including on nasal tip collapse or widening of the nose base, were negligible.
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Affiliation(s)
- Yong-Seok Cho
- Oral and Maxillofacial Surgery, Apsun Dental Hospital, Seoul, South Korea
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