Video Standards for Rhinoplasty Education: A Review and Recommended Guidelines.

Importance: Intraoperative videography is widely used to record rhinoplasty procedures, yet little is known about the optimal surgical vantage points at critical procedural steps. Objective: To assess commonly used camera angles in public and proprietary intraoperative rhinoplasty videos and discuss approaches to obtaining these viewing angles. Design: Public and propriety rhinoplasty videos were reviewed and categorized based on procedure type, specific area(s) of focus, and camera angles utilized at a series of critical operative steps. The most commonly used camera angles were recorded and assessed based on surgical field visualization and the authors' personal recording experiences. Results: Of the 114 videos that met inclusion criteria, 49 were full-length open rhinoplasty procedures, 20 full-length endonasal rhinoplasty procedures, 17 tip techniques, 8 opening techniques, 7 fashioning grafts, 7 osteotomies, and 6 cartilage harvests. With respective to footage acquisition, the upward camera angle was most frequently used for recording, and endoscopic view was least frequently used. Conclusions and Relevance: These findings demonstrate that there is extensive variability in camera angles between surgical films. Moreover, many of these camera angles are insufficient due to obstruction by surgical staff, inability to visualize deep structures, and difficulty capturing the three-dimensional nasal framework. A guide indicating the best viewing angles for different aspects of the procedure would be useful to optimize educational videos.

State of the art in augmentation rhinoplasty: implant or graft?

PURPOSE OF REVIEW: There is ongoing debate regarding the optimal material for augmentation rhinoplasty. Each graft and implant has its own advantages and disadvantages. This review addresses the use of several grafts and implants in augmentation rhinoplasty, with a particular focus on dorsal augmentation. RECENT FINDINGS: There are several grafts and implants available for dorsal augmentation. Autologous graft is commonly reported to be the preferred method. However, the proper selection of graft material varies depending on the technique and preference of the surgeon, as well as the anatomic and ethnic characteristics of the patient. Thus, there are a number of different options in the choice of graft or implant material, and there are debates and controversies as to the most appropriate choice. SUMMARY: This article summarizes the advantages and disadvantages of several graft and implant options for dorsal augmentation. This information can help proper selection of the appropriate implant for dorsal augmentation, a critically important factor for minimizing morbidity while still achieving an optimal aesthetic result.