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Correction of Maxillary Deficiencies in Deviated Nose Rhinoplasty

Asymmetry of the nose occurs for a variety of anatomic reasons. Septal deviation, nasal bone asymmetries, upper lateral and lower alar cartilages differences and even the thickness of the nasal skin are all well recognized contributors to nasal asymmetries. Many standard rhinoplasty maneuvers can help improve the centric alignment of nasal appearance. One less recognized Read More…

Plastic Surgery Case Study – Nostril Narrowing after LeFort I Osteotomy

Background: The LeFort I osteotomy is a well known midface procedure that repositions the upper jaw bone. To perform the procedure a complete subperiosteal undermining is needed across the entire maxilla including around the pyriform aperture. A well known adverse aesthetic sequelae of this procedure is widening of the nostrils due to the lateral pull Read More…

Custom Infraorbital-Malar Implant Designs and Rhinoplasty

The most effective method to treat undereye hollows and flat cheeks associated with a skeletal deficiency (as evidenced by a negative orbital vector) is with custom infraorbital-malar implants. By augmenting the associated and connected skeletal parts around the eye and out onto the cheek produces a smooth augmentation that can look natural because of the Read More…

OR Snapshots – Rib Graft Rhinoplasty for Scarred Collapsed Nasal Tip

Revisional rhinoplasty frequently needs cartilage grafts to be successful. This is particularly relevant when structural deficiencies has occurred resulting in an underprojected nose, breathing difficulties due to middle vault collapse or both. Often, however, the regional harvest sites of the septum and ear have been exhausted or have insufficient volume for the needed nasal support Read More…

Technical Strategies – Subcostal Harvest Site in Rib Graft Rhinoplasty

The use of cartilage grafts is an essential need in many primary and revisional rhinoplasty surgeries. Most such grafts come from either direct anatomic proximity (septum) or from a regional source. (ear) But when these sites are inadequate due to lack of graft material or the volume of material exceeds their capacity, the more distant Read More…

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