Nasal or canthal-alar parentheses: A study of the facial base of the nose

Facial Surface Anthropometric Features and Measurements With an Emphasis on Rhinoplasty

BACKGROUND

Facial features and measurements are utilized to analyze patients' faces for various reasons, including surgical planning, scientific communications, patient-surgeon communications, and post-surgery evaluations.

OBJECTIVES

There are numerous descriptions regarding these features and measurements scattered throughout the literature, and the authors did not encounter a current compilation of these parameters in the medical literature.

METHODS

A narrative literature review of the published medical literature for facial measurements used for facial analysis in rhinoplasty was conducted through the electronic databases MEDLINE/PubMed and Google Scholar, along with a citation search.

RESULTS

A total of 61 facial features were identified: 45 points (25 bilateral, 20 unilateral), 5 lines (3 bilateral, 2 unilateral), 8 planes, and 3 areas.A total of 122 measurements were identified: 48 distances (6 bilateral, 42 unilateral), 57 angles (13 bilateral, 44 unilateral), and 17 ratios. Supplemental figures were created to depict all features and measurements utilizing a frontal, lateral, or basal view of the face.

CONCLUSIONS

This paper provides the most comprehensive and current compilation of facial measurements to date. The authors believe this compilation will guide further developments (methodologies and software tools) for analyzing nasal structures and assessing the objective outcomes of facial surgeries, in particular rhinoplasty. Moreover, it will improve communication as a reference for facial measurements of facial surface anthropometry, in particular rhinoplasty.

Septorhinoplasty by disarticulation

Septorhinoplasty by disarticulation is an esthetic and functional solution for naturally occuring nasal pyramid dysmorphia, releasing the anatomic traces of growth-related stresses. Disarticulating the septolateral cartilage from its bony framework via a closed approach to the septal pocket is associated to Rethi's external approach in order to disarticulate the fibrocartilaginous nasal dorsum, while conserving its integrity, under the bony dorsum. The bony pyramid is then disarticulated down to the nasion, after resecting any bone hump, by 2 paramedian and 2 low lateral osteotomies in the basal groove. The lateral sides of the bony pyramid are then fractured at their posterior edges by percutaneous pinching to close the open roof and realign them along the midline. The septolateral cartilage, reduced as necessary at the inferior and anterior edges, is thereafter repositioned on the premaxillary bone. Traction on its anterior edge restores rectilinear frontal and lateral tension in the fibrocartilaginous dorsum, fully conserved from its attachment to the nasion. This technique corrects any septal deformity and restores frontal and lateral dorsum straightness.