Nasal Skin Thickness Measurements Using Computed Tomography in an Adult Saudi Population.

Rhinoplasty is one of the most challenging operations in plastic surgery, and nasal skin thickness is a significant factor in determining rhinoplasty success. Only a few studies have measured nasal skin thickness before rhinoplasty. The present study was designed to measure nasal skin thickness to shed light on its importance to successful rhinoplasty. METHODS: Altogether, 60 patients underwent measurements of nasal skin thickness at 4 aesthetic points: nasion, rhinion, nasal tip, columella. The thickness was measured using computed tomography (CT), an objective, reliable tool for this purpose. Universally adopted Hounsfield unit measurement using in house software (Consultant Radiology Center, Riyadh, Saudi Arabia) was performed using CT scan. RESULTS: The study group included 32 women and 28 men. Age range was 18-68 years, but most of the patients (53.3%) were within the 20-30-year age range. CT results showed that the mean nasal skin thickness was 3.96 ± 1.08 mm at the nasion, 1.86 ± 0.62 mm at the rhinion, 3.32 ± 0.78 mm at the nasal tip, and 3.32 ± 0.73 mm at the columella. When the nasal skin thicknesses were compared between men and women, a significant difference was observed only at the columella (P = 0.016). CONCLUSIONS: The nasal skin is thickest at the nasion, thinner at the rhinion, and again thicker at the nasal tip and columella. Our data could be useful for plastic surgeons who could take the patient's own nasal area thickness into consideration when planning his or her rhinoplasty.

Injectable calcium hydroxylapatite for correction of nasal bridge deformities.

BACKGROUND: Minimally invasive procedures for aesthetic surgery have become widely popular, and facial soft tissue augmentation is one of the most common procedures. Various kinds of fillers have been used, and recently the use of calcium hydroxylapatite was extended to cosmetic facial procedures. This article presents the authors' experience with primary and secondary nasal bridge correction using calcium hydroxylapatite (Radiesse). METHODS: This preliminary prospective study investigated the use of commercially available calcium hydroxylapatite (Radiesse) for correction of nasal bridge deformities. Calcium hydroxylapatite was injected on the plane of the periosteum in a retrograde fashion using a linear, threading, fanning, or crosshatching technique. The patients were followed for several months, with the outcome and side effects assessed both subjectively and objectively. RESULTS: Patients showed a persistence of benefit up to 1 year during the follow-up period, with pleasing long-term results. CONCLUSION: Calcium hydroxylapatite (Radiesse) is a useful injectable filler for correction of nasal bridge deformities. Further efficacy studies seem justified.

Advantages and outcomes in subfascial breast augmentation: a two-year review of experience.

BACKGROUND: One of the most popular surgical cosmetic procedures, breast augmentation, has enjoyed large acceptance in the last few decades. One of the most important factors in the dynamics established between the implants and the soft tissues after breast augmentation is the pocket plane. Surgeons have been seeking the proper plane into which the implant might be placed. The subglandular approach resulted in implant edge visibility and was thought to result in a higher incidence of fibrous capsular contractures. Despite the advantage of concealing the implant edges using the subpectoral approach, implant displacement occurred with contraction of the pectoralis muscle. The use of the retrofascial plane seems to yield the benefits of both planes without the deficits. METHODS: Since 2006, 45 patients with hypomastia have undergone subfascial breast augmentation using anatomical contour profile gel cohesive III textured implants. RESULTS: Pleasing long-term results have been obtained by using subfascial breast augmentation, with maintenance of a natural breast shape and a smooth transition between the soft tissue and implant in the upper pole. There were no capsular contractures and no complaints regarding displacement of the implants with contraction of the pectoralis major muscle. CONCLUSIONS: The subfascial breast augmentation technique offers improved long-term aesthetic results because the dynamics between the implant and soft tissues have been optimized. This technique is extremely versatile and may also be used in patients requiring removal and replacement of breast implants.