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Facial Plast Surg 2019; 35(05): 492-498
DOI: 10.1055/s-0039-1695726
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Dorsal Augmentation in Facial Profiloplasty

Yong Ju Jang
1   Department of Otolaryngology, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea
,
Shin Hyuk Yoo
1   Department of Otolaryngology, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea
› Author Affiliations
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Publication History

Publication Date:
22 October 2019 (online)

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Abstract

Nasal profile line has central importance in forming an aesthetically balanced facial profile. Thus, rhinoplasty is a critically necessary surgery in shaping ideal profile line. For successful rhinoplasty, meticulous preoperative evaluation and proper planning should be performed before surgery. The nasal dorsum is the broadest and most prominent part of the nose; any minor imperfection is readily appreciated by an observer. Thus, dorsal augmentation is one of the most challenging areas in rhinoplasty as there is virtually no single ideal graft material and method for the nasal dorsum, which is free of aesthetic complication The surgeon should be able to discern the pattern of the abnormal nasal profile and to strategize the best possible surgical option to create a long-lasting, aesthetically pleasing dorsal line in good harmony with the overall facial profile. This study addresses our strategy to deal with various types of aesthetically unpleasant nasal profile line. The characteristics of augmentation materials and considerations in surgical technique are also addressed.

Keywords

facial profiloplasty - rhinoplasty - dorsal augmentation
 

  • References

  • 1 Jang YJ, Alfanta EM. Rhinoplasty in the Asian nose. Facial Plast Surg Clin North Am 2014; 22 (03) 357-377
    CrossrefPubMedGoogle Scholar
  • 2 Jang YJ, Moon BJ. State of the art in augmentation rhinoplasty: implant or graft?. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (04) 280-286
    CrossrefPubMedGoogle Scholar
  • 3 Jang YJ, Yi JS. Perspectives in Asian rhinoplasty. Facial Plast Surg 2014; 30 (02) 123-130
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Jang YJ, Kim SA, Alharethy S. Failure of synthetic implants: strategies and management. Facial Plast Surg 2018; 34 (03) 245-254
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Yu MS, Jang YJ. Preoperative computer simulation for Asian rhinoplasty patients: analysis of accuracy and patient preference. Aesthet Surg J 2014; 34 (08) 1162-1171
    CrossrefPubMedGoogle Scholar
  • 6 Na HG, Jang YJ. Dorsal augmentation using alloplastic implants. Facial Plast Surg 2017; 33 (02) 189-194
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Lee HJ, Jang YJ. Correction of saddle and short noses. Curr Opin Otolaryngol Head Neck Surg 2016; 24 (04) 294-299
    CrossrefPubMedGoogle Scholar
  • 8 Jang YJ, Kim JH. Classification of convex nasal dorsum deformities in Asian patients and treatment outcomes. J Plast Reconstr Aesthet Surg 2011; 64 (03) 301-306
    CrossrefPubMedGoogle Scholar
  • 9 Jang YJ, Min JY, Lau BC. A multilayer cartilaginous tip-grafting technique for improved nasal tip refinement in Asian rhinoplasty. Otolaryngol Head Neck Surg 2011; 145 (02) 217-222
    CrossrefPubMedGoogle Scholar
  • 10 Hyun SM, Jang YJ. Treatment outcomes of saddle nose correction. JAMA Facial Plast Surg 2013; 15 (04) 280-286
    CrossrefPubMedGoogle Scholar
  • 11 Chen YY, Jang YJ. Refinements in saddle nose reconstruction. Facial Plast Surg 2018; 34 (04) 363-372
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Kim JS, Khan NA, Song HM, Jang YJ. Intraoperative measurements of harvestable septal cartilage in rhinoplasty. Ann Plast Surg 2010; 65 (06) 519-523
    CrossrefPubMedGoogle Scholar
  • 13 Kim JH, Jang YJ. Use of diced conchal cartilage with perichondrial attachment in rhinoplasty. Plast Reconstr Surg 2015; 135 (06) 1545-1553
    CrossrefPubMedGoogle Scholar
  • 14 Daniel RK. Diced cartilage grafts in rhinoplasty surgery: current techniques and applications. Plast Reconstr Surg 2008; 122 (06) 1883-1891
    CrossrefPubMedGoogle Scholar
  • 15 Antohi N, Isac C, Stan V, Ionescu R. Dorsal nasal augmentation with “open sandwich” graft consisting of conchal cartilage and retroauricular fascia. Aesthet Surg J 2012; 32 (07) 833-845
    CrossrefPubMedGoogle Scholar
  • 16 Gruber RP, Pardun J, Wall S. Grafting the nasal dorsum with tandem ear cartilage. Plast Reconstr Surg 2003; 112 (04) 1110-1122 , discussion 1123–1124
    CrossrefPubMedGoogle Scholar
  • 17 Varedi P, Bohluli B. Dorsal nasal augmentation: is the composite graft consisting of conchal cartilage and retroauricular fascia an effective option?. J Oral Maxillofac Surg 2015; 73 (09) 1842.e1-1842.e13
    CrossrefPubMedGoogle Scholar
  • 18 Jang YJ, Song HM, Yoon YJ, Sykes JM. Combined use of crushed cartilage and processed fascia lata for dorsal augmentation in rhinoplasty for Asians. Laryngoscope 2009; 119 (06) 1088-1092
    CrossrefPubMedGoogle Scholar
  • 19 Moon BJ, Lee HJ, Jang YJ. Outcomes following rhinoplasty using autologous costal cartilage. Arch Facial Plast Surg 2012; 14 (03) 175-180
    PubMedGoogle Scholar
  • 20 Park JH, Jin HR. Use of autologous costal cartilage in Asian rhinoplasty. Plast Reconstr Surg 2012; 130 (06) 1338-1348
    CrossrefPubMedGoogle Scholar
  • 21 Joo YH, Jang YJ. Comparison of the surgical outcomes of dorsal augmentation using expanded polytetrafluoroethylene or autologous costal cartilage. JAMA Facial Plast Surg 2016; 18 (05) 327-332
    CrossrefPubMedGoogle Scholar
  • 22 Gordon CR, Alghoul M, Goldberg JS, Habal MB, Papay F. Diced cartilage grafts wrapped in AlloDerm for dorsal nasal augmentation. J Craniofac Surg 2011; 22 (04) 1196-1199
    CrossrefPubMedGoogle Scholar
  • 23 Tasman AJ. Replacement of the nasal dorsum with a diced cartilage glue graft. Facial Plast Surg 2019; 35 (01) 53-57
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Erol OO. The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 2000; 105 (06) 2229-2241 , discussion 2242–2243
    CrossrefPubMedGoogle Scholar
  • 25 Bullocks JM, Echo A, Guerra G, Stal S, Yuksel E. A novel autologous scaffold for diced-cartilage grafts in dorsal augmentation rhinoplasty. Aesthetic Plast Surg 2011; 35 (04) 569-579
    CrossrefPubMedGoogle Scholar