Cosmetic surgery method for hooked nose

Description

How to shape a beak nose

[0001] The present invention relates to a method for forming a beak nose.

[0002]

[0003] Septal reduction is a very common rhinoplasty procedure in Western countries. Conventional beak reduction often presents aesthetic and functional problems if the middle turbinate is not reconstructed properly. Recently, interest in conservative rhinoplasty (DPR), which preserves the nasal septum and cartilage using beak reduction, has been resurging in the West. Preserving the entire structure of the nasal pyramid is an attractive concept.

[0004] Compared to Western noses, Asians have a smaller, less supportive nose tip and a lower columella. Therefore, rhinoplasty for Asians to correct a beaked nose typically involves redistributing the nasal profile rather than simply removing the beak. The concept of deep-pull nasal reshaping (DPR) for beaked nose correction is not widely known in Asian countries.

[0005]

[0006] The present invention aims to confirm the possibility of conservative plastic surgery in Asian beak nose plastic surgery.

[0007]

[0008] The present invention relates to a method for shaping a beak-nose by performing a conservative rhinoplasty without completely removing the nasal hump of an Asian beak-nose.

[0009]

[0010] The present invention has confirmed that excellent aesthetic and functional results can be obtained through conservative rhinoplasty in Asians with a beaked nose.

[0011]

[0012] Figure 1 is an example of septal management in conservative rhinoplasty of an Asian beak nose.

[0013] Figure 2 is a photograph during surgery to disguise step-off deformity.

[0014] Figure 3 is a drawing showing the anthropometric measurements of conservative rhinoplasty, including facial angle and height.

[0015] Figure 4 is a photograph showing the improvement in the aesthetic contour of the nose after surgery.

[0016]

[0017] The present invention is described in detail below.

[0018]

[0019] Example

[0020] Patients and Methods

[0021] Surgical technique

[0022] Lowering the hump

[0023] All patients underwent DPR using an open approach under general anesthesia. A lateral fibular incision and a horizontal fibular incision were performed. After septal correction, osteochondral volume was mobilized as a unit to lower the dorsal hump. The hump was lowered using either the push-down or let-down technique.

[0024]

[0025] Septal management

[0026] Considering the need for future tip modification, the septum was approached anteriorly after dome division. The severe septal deviation was corrected, and septal cartilage was harvested for grafting, leaving an L-strut. Septal bone was removed as needed for septal deviation correction. The dorsal-inferior portion of the ethmoid bone was removed. A high dorsal cartilaginous strip was resected from the remaining L-strut along the convex portion of the hump, leaving a 3-5 mm superior strip and a 3-5 mm inferior dorsal cartilaginous strip (Fig. 1). If necessary, an additional vertical incision was made along the dorsal-inferior portion of the remaining septal cartilage in the center of the kyphotic hump to facilitate lowering the hump. To promote effective hump descent, cartilaginous suture adaptation was performed along the resection.

[0027]

[0028] Step-off camouflage

[0029] In the transverse osteotomy area, where a significant amount of vertebral descent was required, a slight step-off deformity developed between the superior and inferior nasal arches. This step-off deformity was often apparent during palpation, especially in patients with a relatively large kyphotic hump and low muscle tone. When palpated externally, the deformity was camouflaged with finely chopped cartilage reinforced with autologous blood. Figure 2 shows intraoperative photographs for camouflaging the step-off deformity. ((Left) Step-off deformity observed at the transverse osteotomy site (black arrowhead). (Middle) Ready-to-use finely chopped cartilage reinforced with blood. (Right) Reinforced chopped cartilage pasted around the step-off deformity (white arrowhead)).

[0030]

[0031] Glabellar and nasal bone care

[0032] To achieve a harmonious profile, complementary surgery using cartilage grafts was performed on the glabella and nasal bones, depending on the desired glabella and nasal shape. Three techniques were used alone or in combination for glabella modification: septal extension grafting, columellar strutting, and tip onlay grafting. When necessary, septal grafting was performed using continuously trimmed cartilage fixed with autologous blood to obscure bone abnormalities.

[0033]

[0034] Aesthetic and functional outcome measurements

[0035] We used lateral views of standardized photographs of the patients. Changes in the nasofrontal angle (NFrtA), nasofacial angle (NFcA), nasolabial angle (NLA), rhinion angle (RA), radix height, dorsal hump height, nasal length, and nasal tip projection were observed. For objective evaluation, two nasal surgeons who were unaware of clinical information analyzed anthropometric factors. Each anthropometric measurement was performed using Adobe Photoshop 2020 (Adobe Systems, Inc., San Diego, CA).

[0036] By definition, NFrtA reflects the angle between the nasolabial line, defined as the line from the tip to the tip, and the glabellar line, defined as the line from the tip to the glabellar line. Figure 3 illustrates anthropometric measurements of conservative rhinoplasty, including facial angles and heights. NFcA represents the angle between the nasolabial line and the glabellar line at the Pogonian line. NLA represents the angle between the line tangent to the bridge of the nose and the labial limb line below the bridge. To evaluate the effectiveness of aquiline correction, RA, which represents the angle between the nasolabial line and the tip line, was measured. Radial height was measured from the anterior cornea to the tip of the nose. Preoperative aquiline height was measured as the longest distance between the nasolabial line and the tip of the nose. In addition, nasal length (tip-to-tip) and tip projection (tip-to-nasal projection) were measured. Because standardized photographs of selected patients were reviewed retrospectively, the results of length changes were expressed as a percentage using the ratio of preoperative and postoperative values.

[0037] Additionally, the Nasal Obstruction Rating Scale was used to assess functional outcomes. Cosmetic surgery outcomes were assessed through a patient questionnaire using a scale from 0 to 3. All statistical analyses were performed using SPSS 25.0 (IBM Corp., New York, NY). Mann-Whitney U tests and Wilcoxon signed-rank tests were performed. All tests were two-sided, and a P value less than 0.05 was considered statistically significant.

[0038]

[0039] result

[0040] Demographics and preoperative patient characteristics (Table 1)

[0041] Four males and five females were included. The mean age was 23.0 years, and the mean follow-up period was 8.3 months. The mean height of the nodules was 2.37 mm. All patients had bulbous and protruding nodules. Five patients had both a crooked and protruding nose when viewed from the front.

[0042]

[0043]

[0044] Changes in anthropometric factors

[0045] The mean NFcA decreased from 34.32°C to 26.43°C (P = 0.008), and RA showed a significant decrease from 8.07°C to 1.89°C (P = 0.008). According to these results, there were significant changes in both NFcA and RA, indicating successful hump correction. However, NFrtA and NLA did not change significantly after surgery. The nasal tip height, nasal length, and nasal tip projection length showed significant changes of 113.52% (P = 0.02), 90.52% (P = 0.011), and 111.9% (P = 0.011), respectively.

[0046]

[0047] Functional and aesthetic results

[0048] The overall aesthetic contour of the nose improved after surgery (Fig. 4). The Nasal Obstruction Symptom Assessment Scale showed a postoperative improvement in breathing from 57.00 to 18.33 in all nine patients (P = 0.008). The subjective aesthetic outcome questionnaire showed a score of 2.78, indicating a very satisfactory outcome. No residual nodules, recurrence of nodules, or saddle nose deformity were observed at the final follow-up.

Claims

1. A method of plastic surgery for a beak nose that performs conservative rhinoplasty without completely removing the nasal hump in Asian beak noses.

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