Index. Blunt perichondrium elevator, 164 Bone paste, 85 Bone scissors, 35 36, 128, 328

Transcription

1 A Alar rim edge excision incision, 311 marking, 311 resection, 312 suture, Arkansas stone, 254 Autorim flap technique ala retractions, 145 alar support, 158 bulbous cartilage, 150 cartilage surface, 154 caudal excess, 148, 160 cephalic dome sutures, 156 cephalic migration, 150 cephalic resection, 155 cephalic trimming, 147 columellar strut graft, 156 convex lateral crura, 149 C suture, 157 desired facet polygon, 152 dissection, 154 dome lights, 159 facet polygon, 145 lateral crus caudal resections, 145 medial crus, 153 mucosa, 153 narrow facet polygon, 152 nostril, 162 preoperative photograph, 158 in situ cartilages, 151 structural grafts, 159 subperichondrial plane, 154 thin skinned patient, 146 Awareness, 40 B Bayonet forceps, 257, 325, 330 Black dots, 18 Block cartilage, 52, 53, , 374, 395 Blunt perichondrium elevator, 164 Bone paste, 85 Bone scissors, 35 36, 128, 328 C Cakir perichondrium elevator, 36 Cakir periosteum elevator, 36, 113, 115 Camouflage techniques, 85, 183, 324 Cartilage anatomy, 47, 48, 55, 69 Cartilage hump, 126, 274, 281, 359 Cavity polygon, 61 Cephalic malpositioning patient analyses autorim flap, 377 columellar polygon, 378 domes and strut graft, 377 infralobule polygon, 378 lateral crural steal, 377 single flash photo, 376 resting angle autorim flap technique, 79 insufficient cartilage in nose wings, 79 lateral crus repositioning surgery, 78 medial canthus, 78 repositioning technique, 80 subperichondrial dissection, 79 Choking graft sutures, 222 Closed approach healing rate closed technique, 365 depressor, 364 infralobule polygon, 364 scroll facets, 366 soft tissue resection, 364 ideal patient for, revision lateral steal simulation, 380 marking and symmetry test, 380 operation, 380 tip surgery, 381 Springer International Publishing Switzerland 2016 B. Çakır, Aesthetic Septorhinoplasty, DOI /

2 416 Columellar show autorim flap technique, 340 closed technique, 340 hanging columella closed technique and extreme cephalic resection, 341 lateral crural cephalic strut graft, medial crus caudal resection, scroll graft, surgery, retracted nasal alae, 339 upper lateral cartilage caudal resection, 340 Computer imaging designs, 10, 16 Concha hypertrophic concha, 101 radiofrequency cauterization, 101 SMR bone pieces, 103 cavernous tissue, 102 concha bone, 105, 106 conchal mucosa, 104 electro cautery, 104 elliptic resections, 102 inward collapsed maxillary base, 106 local anesthesia, 101 normal anatomy, 106 saline solution, 101 segmental outfracture, septum base, 105 silicon splint, 104 Webster triangle out fracture, 106 D Daniel perichondrium elevator, 36, 37, 124, 125, 166 Defatting, 297 Degussit (Al2O3), 38 Dome anatomy, 57 Dome spanning, 57, 63 Dome symmetry test, , 326 Dome triangles, 54 57, 204, 217 Dorsal bone polygon, 53, Dorsal cartilage polygon, 53, E Esthetician, 18 Extreme grafting, 61 F Fish-eyed photo, 7 Focus settings, 8 Forehead fat grafting cannula, 19 chin prostheses, 19 fat injection, 19 lipofilling, 19 nose aesthetics, 19 nose radix, 19 technique alae rim resection, 25 blunt radix, 25 dorsal aesthetic lines, 24 fat injection, 21, 25 forehead nose transition, 21 nose surgery, 20 postoperative results, 21 rhinoplasty, 21 sagging alae, 25 surgical plan, 26 tip shadows, 24 F value, 8 G Glabellar polygon, 53 Gummy smile deformity, 138, 139 H Hanging columella closed technique and extreme cephalic resection, 341 lateral crural cephalic strut graft, medial crus caudal resection, scroll graft, surgery, Hematoma, 123 Hemitransdomal suture, 196, 199 I Intracath, 19, 28, 288 ISO, 8 J Jaw and cheek arkansas stone, 38 bone scissors, under chin approach, 28 chin augmentation, 28 elevator, eyelash and nose relation, 33 forehead fat injection, 30 gray intracath, 28 hook, 37 illusion effect, 32 lateral osteotomes, 37 medpor implants, 28 monocryl stitch, 28 needleholde, 35 osteotomes, 36 osteotomy chisels, 37 rasp and saw, 36 scissors, 35 subperichondrial dissection, 34 sutures, 38

3 417 L Lateral crus subperichondrial dissection autospreader flap technique, 162 blunt perichondrium elevator, 164 cephalic malposition, 177 Daniel elevator, 166 domes, delivering, ellipse model, internal bandaging, 165 marking and resections, observations, scroll ligament, 165 secondary rhinoplasty, sesamoid cartilages, 165 thoery, tools, 163 Learning, nose drawing polygons, 39 sculpture classes, 39 sketch from front, Little Cottle elevator, 36, 37 M Mass polygons, 53, 65 Maxillary spine, 325 Menstrual delaying medicine, 19 Millimeter autorim flap, 242 Mucosa surplus, 330 Mucosa vasoconstriction, 96 Muscle function impairment, 122 N Nasal dorsum surgery bone dust and cartilage paste, dorsal bone resection, dorsal cartilage resection, dorsal reconstruction, males, dorsum height, 252 intercartilaginous incision, 108 nasal radix, nasal tip, stabilization of, osteoectomy technique aspirator tip, 258 blind chisel, 257 bone massage, bone saw dusts, 257 bone surface problems, 263 breathing problems, 265 bruising, 263 control, 262 function, 263 instruments, Libra graft, nasal dorsum cartilage, 274 nasal dorsum control, rasp, 255 reconstruction, nasal dorsum, redrape problems, 264 scratching movements, 257 superficial bone asymmetries, 256 unsuccessful osteotomy, 263 osteotomy, periosteum dissection, scroll groove, reconstruction of 5/0 Monocryl, 283 scroll sesamoid cartilage, septum mucosa, 283 septal angle, short nasal bones, subperichondrial dissection bleeding, 123 camouflage effect, 123 ligaments, muscle function, nose healing, 122 open approach, transfixion incision, 107 upper lateral cartilage mucosa dissection, Nasal polygons Cakir polygons vs. Sheen s aesthetics, columellar polygon, dome triangles cartilage anatomy, 55 cephalic dome suture, 56, 57 cubic forms, 57 facet polygon, 56, 57 horizontal mattress suture, 57 lateral and medial crura, 55 organic models, 57 tip sutures, 55 Ti, Ts and Rm points, 54 dorsal aesthetic lines fusiform anatomy, 87 Libra graft technique, 87 nasal dorsum, 87 nose aesthetic design, 87 oblique view, 87 review, 90 rib graft, 88, 89 dorsal bone polygon, dorsal cartilage polygon, facet polygons destruction, 64 dome polygon, 63, 65 infralobular polygon, 63 lateral crus, caudal edge of, 63 middle crus, 63 non-anatomical sutures, 63 open surgery technique, 64 pinched nose deformity, 64 footplate polygon, infralobular polygon, 60 infratip triangle, 53 interdomal triangle

4 418 Nasal polygons (cont.) dome divergence, facet polygon, 58 photoshop, 58 rim graft, 58 rotation differences, 58 lateral aesthetic lines, 92 lateral bone polygons, 86 lateral crus polygons, 65 mobile tip area space polygons, mass polygons, 53 non-mobile nose, 53 polygon model, resting angle cephalic dome suture, 66 cephalic malpositioning, convex lateral crura, 78 incorrect resting angle, long lateral crura, surgical techniques, 66 vertical compression test, wide lateral crura, 71 scroll facet cephalic dome suture, 80 dome cartilages, 81 open technique, 82 transdomal sutures, 82 scroll line, 83 tip breakpoints, 54 tip defining point, 53 upper lateral cartilage polygons, Nasal surgery additional grafts extra columellar strut, rim graft, 298 basic surgical steps, 101 cartilage grafts rib cartilage, septal cartilage, 334 cleaning, 99 columellar show autorim flap technique, 340 closed technique, 340 hanging columella, 339, retracted nasal alae, 339 upper lateral cartilage caudal resection, 340 concha, deviated nose left axis noses, nasal dorsum resection, reference points, septoplasty, septum deviation, 320 tip surgery, drains, 288 drawings, footplates anterior maxillary spine resections, 142 contralateral footplate, 141 septum cartilage, 140 suturing of, 143 transfixion incision, 141 head lamp, 99 internal splints, 288 internal taping new SMAS anatomy, Pitanguy ligament, internal valve functions, 288 lights, operating room, local anesthesia Bupivacaine, 98 infiltration, 97 infraalveolar and supratrochlear blocks, 98 Lidocaine, 98 nasal dorsum dissection, 99 nasal dorsum surgery, , nostril surgery avulsion advancement flap, avulsion advancement flap and elliptic resection combination, composite graft, hanging alae, problems and solutions, 299 thick alar base, patient position and tracheal intubation, Pitanguy ligament, postoperative care, prescription, 349 redrape camouflage, 297 dissection borders, internal taping, ligaments, 296 results cephalic dome suture, cephalic malpositioning, cephalic malposition view, 186 C graft, closure of tip incisions, columellar breakpoint (C point), 218 columellar polygon stabilization, columellar strut graft, Control 1, 198 Control 2, C suture, domes, suturing, dome symmetry test, footplate setback, infralobular caudal contour graft, interdomal graft, lateral crus steal procedure, medial crus overlap, nose movement, 186 surgery, 187 tip asymmetry, septum, superficial SMAS, taping, tip surgery,

5 Nasolabial angle, 42, 184 Needle hooks, 229 Nose drawing design, 39 learning polygons, 39 sculpture classes, 39 sketch from above and below, sketch from front, sketch from side, patient photographs, analysis of, Nose sculpture, 45, 51 Nostril sill anatomy, 40, 302, 307 O Open roof, 36, 85, 262, 264 Oral Vitamin A, 18, 119 Organic models, 53, 57 Osteoectomy technique aspirator tip, 258 blind chisel, 257 bone massage, bone saw dusts, 257 bone surface problems, 263 breathing problems, 265 bruising, 263 control, 262 function, 263 instruments, Libra graft, nasal dorsum cartilage, 274 nasal dorsum control, rasp, 255 reconstruction, nasal dorsum, redrape problems, 264 scratching movements, 257 superficial bone asymmetries, 256 unsuccessful osteotomy, 263 P Paraflash system, 5, 7, 8 Patient analyses after surgery, 414 bulbous tip, , cephalic malpositioning autorim flap, 377 columellar polygon, 378 domes and strut graft, 377 infralobule polygon, 378 lateral crural steal, 377 single flash photo, 376 closed approach healing rate, ideal patient for, revision, common patient alar edge resection, 354 lateral crus caudal edge, 353 nose tip cartilages, nose tip rotation, 402 resection, 353 rotation, 352 subperichondrial dissection, 352 dermocartilaginous ligament, 359 dome triangles, 359 droopy tip, footplate setback effect, 362 fractured nose, operated twice calvarium bone graft, 372 cartilage chip grafts, 373 fusiform nasal dorsum graft, 373 resection, 372 silicon graft, 373 surgery, 374 long nose, mid-thick skin surgery, surgery photographs, open technique, 359 overrotated saddle nose cymba conchae, 382 first operation, second operation, 383 surgery, Pitanguy ligament, 360 6/0 Prolene suture, 360 saddle nose and hanging nostril, and notched nostril, subperichondrial dissection, 360 supratip healing period depression, 366 nasal dorsum, 368 Pitanguy ligament, 366 scroll ligament, 366 tip surgery, 367 before surgery, tension nose, tension nose and thin skin, thick skin bulbous tip and deviated nose, and huge hump, low radix and cephalic malpositioning, and oily skin, patients, thin skin axis deviation and breathing problems, big nose, deviated nose and tip asymmetry, patients, pseudocephalic malpositioning and tip asymmetry, tip asymmetry, very short infralobule and very narrow facet polygon, wide dorsum, wide radix and bulbous overprojected tip first surgery, 369 infralobule polygon length, 368 two year revision,

6 420 Patient photographs camera settings, 7 8 fish-eye, 7 image workout, light tricks, 6 7 paraflash settings, 8 peroperative photographs, 6 photography system, 5 6 shadpowing, workout JPG, 13 layer adjustment menu, 13 Macintosh: cmd-a (Windows: CTRL-A), 12 Macintosh: cmd-c (Windows: CTRL-C), 12 photograph work, PSD format, 13 shaded picture, 14 surgery drawings, 14 smartphone, 7 Peck graft, 204, 227 Perpendicular (portrait) photos, 5 Photograph work aesthetic information feedbacks, 15 beauty perception, 15 brain perception, 14 computer design, 16 design, 14 front, lateral views and shadowed photos, 16 integrated photo, 16 nose ridge, 14 operation room, 16 Photography techniques, 10 Photoshop, 10 12, 58, 100, 184 Polygon drawings, 54, 211 Portrait photographs, 8 Poviodine, 99 Preoperative photographs forehead fat grafting, jaw and cheek, menstruation, 19 patient photographs camera settings, 7 8 fish-eye, 7 image workout, light tricks, 6 7 paraflash settings, 8 10 peroperative photographs, 6 photography system, 5 6 shadowing, smartphone shooting, 7 rhinoplasty instrument set, skin care and rhinoplasty, surgery notes and archiving, Pseudoephedrine spray, 96, 349 R Resting angle cephalic dome suture, 66 cephalic malpositioning autorim flap technique, 79 insufficient cartilage in nose wings, 79 lateral crus repositioning surgery, 78 medial canthus, 78 repositioning technique, 80 subperichondrial dissection, 79 convex lateral crura, 78 incorrect resting angle, long lateral crura airway, 73 caudal excess, 72 closed technique rhinoplasty, 71 depression, 74 height of, 71 herniation, 71, 73, 75 nose length, reduction, 71 perichondrium, 72 skin pit, 75 subperichondrial dissection, 72 surgical techniques, 66 vertical compression test, breathing, 67 cartilage anatomy, 69 cartilage thickness, 67 cephalic malposition deformity, 69, 70 corrupted resting angle, 69 deep inspiration, 67 lateral crus, 67 nares, 67 resistance, 68 septum deviation, 67 tip shaping techniques, 70 wide lateral crura, 71 Reverse-V deformity, 87, 254, 262 Rhinoplasty closed technique, 71 instrument set closed surgery, 34 dorsum retractor, 34 little retractor, Medicon company, 34 speculums, 34 surgical tools, 34 polygon model, skin care and, Rib cartilage block cartilage, cartilage chips, 335 ear cartilage, 335 strip cartilage grafts, surgery, Roaccutane treatment, 18 S Saddle nose and hanging nostril, and notched nostril, Self-sticky prints, 6 Septal extension graft, 228, 267, 293

7 Septum dissection blunt dissectors, 136 ethmoid bone, 135 excised vomer bone, 135 L-strut septoplasty, 132 maxillary spine deviations, 134 mucosa tears, 133 nasal passage, 137 open approach, 132 perichondrium, 131 revision rhinoplasty, 132 rib cartilage, 132 septoplasty, 137 thin Cottle elevator, 132 transfixion incision, 136 extreme gummy smile, gummy smile, 138 septum out, Septum base surgery, 329 Shadowed photos, 100 Shield graft, 52, 53 Shutter rate, 8 Skin color, 8 Skin ecchymosis, 119 SLR camera, 5 7 Surgery notes and archiving autorim flap technique, 18 backups, 18 drawings, 17 epicrisis report, 17 patient archiving programs, 17 photography archive, 18 pre-written surgery note, 17 recordings, 17 T Tebbett s technique, 105 Telangiectasia, 296 Thick skin bulbous tip and deviated nose, and huge hump ala resection, 362 avulsion flap and elliptic resection, 363 patient s infralobule polygon, 362 low radix and cephalic malpositioning, and oily skin alar edge resection, 357 columella, 357 fat injection, 357 long inflammatory period, 357 nostril edge resection, 358 vitamin A, 358 patients closed technique, 355 Libra grafts, 357 osteotomies, 357 pitanguy and scroll ligaments, 355 strut graft, 356 Thin skin axis deviation and breathing problems, big nose, deviated nose and tip asymmetry, patients, pseudocephalic malpositioning and tip asymmetry, Time Machine, 18 Tip surgery autorim flap ala retractions, 145 alar support, 158 bulbous cartilage, 150 cartilage surface, 154 caudal excess, 148, 160 cephalic dome sutures, 156 cephalic migration, 150 cephalic resection, 155 cephalic trimming, 147 columellar strut graft, 156 convex lateral crura, 149 C suture, 157 desired facet polygon, 152 dissection, 154 dome lights, 159 facet polygon, 145 lateral crus caudal resections, 145 medial crus, 153 mucosa, 153 narrow facet polygon, 152 nostril, 162 preoperative photograph, 158 in situ cartilages, 151 structural grafts, 159 subperichondrial plane, 154 thin skinned patient, 146 infracartilaginous incision, lateral crural length, 143 lateral crus subperichondrial dissection autospreader flap technique, 162 blunt perichondrium elevator, 164 cephalic malposition, 177 Daniel elevator, 166 domes, delivering, Ellipse model, internal bandaging, 165 marking and resections, observations, scroll ligament, 165 secondary rhinoplasty, sesamoid cartilages, 165 thoery, tools, 163 nasal dorsum and septal surgery, 143 Tongue-in-groove, 228 Topographic anatomy, 53, 92 Transdomal suture, 64, 82, 196,

8 422 Triamcinolone, 314 Turkish Aesthetic Surgery Society, 161 U Upper lateral cartilage polygons, 53, W Webster s bone triangle, 92 Webster triangle, 92, 106, 254, 263 White steroid cysts, 296