logo logo
3D Virtual Planning for Rhinoplasty Using a Free Add-On for Open-Source Software. Sobral Davi S,Duarte Daniele W,Dornelles Rodrigo F V,Moraes Cícero A C Aesthetic surgery journal BACKGROUND:Rhinoplasty is one of the most frequent aesthetic surgeries; the procedure can be challenging for inexperienced surgeons, and positive outcomes depend on good communication with the patient, proper planning, and precise execution. Three-dimensional (3D) technology has emerged to address these issues, but specific software for 3D planning tends to be expensive. OBJECTIVES:This study presents a simple, low-cost method for 3D simulation to plan rhinoplasty. METHODS:This preliminary report describes 3D rhinoplasty planning in a series of 3 cases employing free software and an add-on especially developed for rhinoplasty (Blender and RhinOnBlender, respectively). The photogrammetry protocol, which can be performed easily with a smartphone, is described in detail along with all the steps in 3D planning. RESULTS:The software and add-on automated the process, making the tool environment accessible to surgeons who are not familiar with graphic design software. The surgeries were uneventful in all cases, and the patients were satisfied with the outcomes. CONCLUSIONS:3D graphic technology has provided significant advances in health research, improvement, and teaching for surgeons and communication between surgeons and patients. Free open-source software and add-ons are excellent options that offer proven utility, affordability, and ease of utilization to healthcare providers. 10.1093/asj/sjab085
Laser-Assisted Rhinoplasty: The Future Generation Rhinoplasty Technique to Preserve Anatomy? A Series of Patients Compared to Patients Undergoing Standard Open Rhinoplasty. Plastic and reconstructive surgery BACKGROUND:Rhinoplasty is the cosmetic procedure that is most difficult to master. Anatomical preservation should represent the main goal of rhinoplasty. One emerging tool appears to be erbium:yttrium-aluminum-garnet laser bone and cartilage reshaping. The authors developed a new small laser hand probe to perform what we called laser-assisted rhinoplasty. The authors evaluate the feasibility of the laser-assisted rhinoplasty and the aesthetic and functional result of laser-assisted rhinoplasty compared to classic rhinoplasty. METHODS:A total of 50 patients were enrolled and randomized into two cohorts: the first cohort of patients was submitted to classic rhinoplasty, and the second cohort to laser-assisted rhinoplasty. The laser beam was used to perform both the resection of the crura and the resection of the nasal hump and osteotomies. RESULTS:Laser-assisted rhinoplasty is a safe and reproducible technique. At a clinical assessment, lateral crura reshaping showed a visible step or excessive skin retraction in 12 percent of the classic rhinoplasty population with thick cartilage and/or thin skin, and this was not present in the laser-assisted rhinoplasty population at 12-month follow-up. The patient satisfaction rate was higher in the laser-assisted rhinoplasty population compared with standard open rhinoplasty. The authors also clinically noted a reduction in edema in the immediate postoperative period in the laser-assisted rhinoplasty population and a more rapid complete resolution of the swelling. CONCLUSION:The laser-assisted rhinoplasty technique is feasible and safe and has no major complication, and the aesthetic and functional results can be superimposed onto classic rhinoplasty but with a higher degree of intraoperative precision, higher patient satisfaction, a cleaner field, and less bleeding. 10.1097/PRS.0000000000007590
Nasal base reduction: a treatment algorithm including alar release with medialization. Gruber Ronald P,Freeman M Brandon,Hsu Charles,Elyassnia Dino,Reddy Vikram Plastic and reconstructive surgery BACKGROUND:The broad nasal base is occasionally not correctable by excisional procedures alone because nostril distortion or stenosis may result (if resection enters the vestibule). Moreover, recurrence is a common problem when alar mobilization and suture approximation techniques are used. The authors developed an algorithm for nasal base reduction to prevent these complications. METHODS:A new classification of the broad nasal base was utilized that included patients with general nasal base enlargement and patients with a vertically oriented alar axis (traditionally difficult to correct without distortion). Both groups received an alar release including the following: (1) the soft tissues and pyriform ligament of the anterior maxilla; (2) the periosteum posterior to the pyriform rim (in the bony nasal vault); and (3) when necessary, soft tissues along the horizontal pyriform rim. Interalar sutures maintained the alae in their new medialized position. Twelve patients who only underwent alar release were evaluated. RESULTS:Nasal base reduction was achieved in all cases without distortion. Three patients required release of the horizontal tissues of the pyriform rim (including a condensation of the pyriform ligament). After a follow-up period of 11 months to 3(3/4) years, there were two cases of partial recurrence and one partial airway obstruction. CONCLUSIONS:Not all causes of a broad nasal base are amenable to resection procedures, especially the generally broad nasal base such as that due to thick skin or a vertically oriented alar axis. However, a tension-free alar release with medialization by suture fixation is effective. The incidence of recurrence can be expected to be reduced. 10.1097/01.prs.0000345598.95343.63
Alar Base Reduction and Alar-Columellar Relationship. Choi Ji Yun Facial plastic surgery clinics of North America Nasal base modification can improve nostril shape and orientation, reduce alar flaring, improve nasal base width, correct nasal hooding, improve symmetry, and create overall facial harmony. For the correction of alar rim deformities, careful examination, consultation, and analysis and consideration of the condition of the skin are essential. Understanding the ala and surrounding tissue, supporting the lower lateral cartilage, and selecting the proper technique produce functionally and aesthetically good results. 10.1016/j.fsc.2018.03.010