ABSTRACT
Presentamos un paciente de 21 años, operado 18 veces en otros centros, y por 19ª vez en nuestra clínica de rinoplastia con secuelas de nariz y labio leporinos que afectaban especialmente a toda la base nasal y al labio: ausencia de columela, narinas muy reducidas y asimétricas, deformidad de alas nasales, labio superior en tienda de campaña con bermellón muy irregular; conservaba el septum aunque la función respiratoria era muy deficiente.Requirió reconstrucción de toda la base nasal y retoque de labio superior y bermellón. Presentamos la secuencia quirúrgica y los resultados postoperatorios a las 2 semanas, a los 6 meses y a los 2 años. (AU)
We present a 21-year-old patient, operated on 18 times in other Centres, and for the 19th time in our clinic, for rhinoplasty in cleft nose and lip sequelae that especially afected the entire nasal base and lip: absence of columella, very reduced nostrils and asymmetric, nasal wing deformity, upper lip in a tent shape with very irregular vermilion; the septum was preserved although respiratory function was very poor.He required reconstruction of the entire nasal base and retouching of the upper lip and vermilion.We present the surgical sequence and postoperative results at 2 weeks, 6 months, and 2 years. (AU)
Subject(s)
Humans , Male , Young Adult , Rhinoplasty , Surgery, Plastic , NoseABSTRACT
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Subject(s)
Humans , Rhinoplasty/methods , Cartilage/transplantation , Connective Tissue/transplantation , EndoscopyABSTRACT
There are many ways to reconstruct and make nasal tips more attractive. Sometimes we cannot find the best way unless we at least remove all surplus from the tip. This may occur in primary or secondary rhinoplasty. In principle, anything is possible when relocating and reconstructing. However, sometimes we face reality when we uncover the tip: broken or bulging cartilages that are difficult to put right. For this reason, in 1987 we thought of totally resectioning the alar cartilages in a case of secondary rhinoplasty with an unsightly appearance. After a year the result was seen to be correct from an aesthetic and a functional perspective and is still so today. Aesthetically, it kept its shape and did not collapse with nasal respiratory failure. We covered the end of the crus medialis with a small, temporary, one- to two-layered fascia patch. Except in exceptional cases, we now use this procedure: Total sectioning of the alar cartilages including the domes, or maintenance of them by preserving the fibroadipose tip tissue with a suture in the middle of the end of the crus medialis and by covering this with temporary fascia, which usually has two layers depending on the thickness of the skin of the tip. This procedure is indicated mainly in secondary rhinoplasty when the cartilages of the tip are completely destroyed, and in primary rhinoplasty when the tip is excessively wide and bulbous. Our philosophy is, therefore, elegance and beauty of the nasal tip with a solid and equilateral base without prejudices.
Subject(s)
Nasal Cartilages/surgery , Rhinoplasty/adverse effects , Rhinoplasty/methods , Esthetics , Female , Humans , Male , Patient Satisfaction , Postoperative Complications/surgery , Reoperation/methods , Risk Assessment , Treatment OutcomeABSTRACT
This paper demonstrates a therapeutic alternative for the reconstruction of the sideburn and temporal area, based on a transposition flap from the retroauricular area. This method allows treatment of the lack of a sideburn and temporal area, which occasionally can be produced as an unfortunate sequela of the face-lift.
