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Luong KP, Slijper HP, Stubenitsky B, Hummelink S, Ulrich DJO. Changes in patient-reported satisfaction and quality-of-life 6 months after rhinoplasty. J Plast Reconstr Aesthet Surg 2024; 91:325-334. [PMID: 38442513 DOI: 10.1016/j.bjps.2024.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/28/2023] [Accepted: 02/04/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Rhinoplasty is a challenging and demanding procedure in plastic surgery. Surgical success, patient satisfaction, and improved quality-of-life are important outcomes. OBJECTIVES This study aimed to evaluate patient-reported satisfaction with appearance, treatment, and decision outcomes as well as quality-of-life after rhinoplasty using validated questionnaires. The role of patient demographics on outcomes was also studied. METHODS Patients who underwent a primary rhinoplasty were selected for this cohort study. Patient-reported satisfaction with appearance, treatment, and decision as well as quality-of-life were evaluated with the Utrecht Questionnaire and FACE-Q at intake and 6 months postoperatively. RESULTS Overall, 380 patients were included. Patients reported a more positive subjective perception of nasal appearance (VAS score) at 6 months post-surgery compared with preoperative scores (7.9 ± 1.6 vs 3.2 ± 1.4, p < 0.05). Furthermore, higher quality-of-life and body image scores were observed at 6 months postoperatively compared with preoperative scores (7.7 ± 3.5 vs 15.2 ± 4.4, p < 0.05). Patients reported high satisfaction with treatment outcome (70.3 ± 23.4) as well as with their decision to undergo surgery (75.9 ± 23.4) on a scale of 0-100 at 6 months postoperatively. Patients reached similar postoperative scores regardless of their intake scores. Patients ≥30 years and patients with a history of cosmetic surgery were less satisfied postoperatively. CONCLUSION Despite differences in appearance satisfaction at intake, most patients showed greater satisfaction with appearance, treatment, and decision outcomes as well as quality-of-life 6 months postoperatively. However, older age and a history of cosmetic surgery influenced these outcomes negatively. These factors should be considered during preoperative management of outcome expectations.
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Affiliation(s)
- K P Luong
- Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6500 HB Nijmegen, the Netherlands; Research Center, Velthuis kliniek, Flight Forum 130, 5657 DD, Eindhoven, the Netherlands.
| | - H P Slijper
- Research Center, Velthuis kliniek, Flight Forum 130, 5657 DD, Eindhoven, the Netherlands; Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - B Stubenitsky
- Dr_BartClinic, Valeriusstraat 55, 1071 MD, Amsterdam, the Netherlands
| | - S Hummelink
- Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6500 HB Nijmegen, the Netherlands
| | - D J O Ulrich
- Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Geert Grooteplein Zuid 10, 6500 HB Nijmegen, the Netherlands; Research Center, Velthuis kliniek, Flight Forum 130, 5657 DD, Eindhoven, the Netherlands
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Bertossi D, Sacchetto L, Chirumbolo S, Panozzo G, Kapoor KM. Single-Step Full-Face Surgical Treatment of the Facial Profile. Facial Plast Surg 2024; 40:9-18. [PMID: 36652954 DOI: 10.1055/a-2015-0853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The present study was performed to describe how much affordable, feasible, and straightforward is the approach the authors called "single-stage full-face surgical profileplasty," tailored to greatly improve the surgery of the facial profiling setting and achieve complete profile correction at the same time. From January 2010 to May 2019, 113 patients (95 females and 18 males; aged 19 - 63 years) were surgically treated for full-face profile amelioration. Profile correction was performed by using a combination of five procedures out of other various previously experienced: forehead fat grafting, rhinoplasty, lip fat grafting, genioplasty, and submental liposuction. All patients were assessed at 1, 3, 6, and 12 months following surgery for assessing the surgical profile treatment (SPT) outcome and any possible side effects of the combined treatment. Facial profile stability at 1 year was taken as the completion point of this treatment. Arnett et al's "Soft Tissue Cephalometric Analysis" (1999) was used to clinically evaluate the soft tissues before and after the SPT. Patients' satisfaction was measured with the Client Satisfaction Questionnaire-8" at 3 and 12 months after surgery. Statistics were used for Arnett et al's evaluation. Almost all the values were consistent and reached the normal ranges indicated by Arnett et al (p < 0.001), confirming that the desired results of the surgical profileplasty have been achieved. Single-stage full-face surgical profile treatment helps in correcting faults of the global facial deformity, in every single treated area, providing an overall improvement in facial aesthetics and harmony. Obtaining the simultaneous correction in the whole face has also the advantage of avoiding multiple surgical procedures, reducing postoperative discomfort, and the overall risks for the patient due to multiple surgical and anesthetic procedures.
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Affiliation(s)
- Dario Bertossi
- Unit of Maxillo Facial Surgery Head & Neck Department, Università degli Studi di Verona, Verona, Veneto, Italy
| | - Luca Sacchetto
- Unit of Maxillo Facial Surgery Head & Neck Department, Università degli Studi di Verona, Verona, Veneto, Italy
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, Unit of Human Anatomy, University of Verona, Verona, Italy
| | - Giorgio Panozzo
- Unit of Maxillo Facial Surgery Head & Neck Department, Università degli Studi di Verona, Verona, Veneto, Italy
| | - Krishan Mohan Kapoor
- Department of Plastic Surgery, Fortis Hospital Mohali, Chandigarh, Punjab, India
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Yu Z, Zhang Z, Wang X, Song D, Yan Q, Sun Y, Xiong X, Meng X, Li W, Yi Z. Psychological evaluation of Asian female patients with rhinoplasty. J Plast Reconstr Aesthet Surg 2024; 88:112-118. [PMID: 37972441 DOI: 10.1016/j.bjps.2023.10.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Patients requiring plastic surgery exhibit more abnormal psychological trends (e.g., body dysmorphic disorder [BDD], depression, and anxiety) than those requiring other surgeries. However, there are only a few domestic studies on the psychological aspects of the population requiring plastic surgery. Therefore, we analyzed the psychological characteristics and psychological impact of rhinoplasty in female patients. METHODS In this study, patients were classified into 2 groups: 151 males and 60 females. The self-rating scale of body image (SSBI), self-rating anxiety scale, self-rating depression scale, and postoperative satisfaction questionnaire were used to examine the patients before and after surgery. The results were analyzed using t-test, analysis of variance, chi-square test, paired rank sum test, and Pearson correlation analysis. RESULTS The total prevalence of BDD in female patients who underwent rhinoplasty was 7.3%. The prevalence of anxiety disorders was 31.8% and that of depression was 45.0%. Female patients with BDD were more likely to exhibit depression (55.5%) and anxiety (36.4%). The SSBI score was related to marital status (p = 0.001) and history of rhinoplasty (p = 0.000). Moreover, there was a significant negative correlation between preoperative BDD score and postoperative satisfaction (r = -0.392, p = 0.002) as well as between the previous history of rhinoplasty and postoperative satisfaction (r = -0.603, p = 0.000). CONCLUSION Pathological psychologies such as anxiety, depression, and BDD are common in patients scheduled to undergo rhinoplasty, and BDD is more likely to be associated with depression. Rhinoplasty has little psychological impact on patients, i.e., it neither causes improvement nor deterioration. Female patients who have undergone rhinoplasty should be considered to a have high risk of BDD. Although the outcomes of surgery are generally quite positive, patients diagnosed with BDD are more likely to be dissatisfied.
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Affiliation(s)
- Zidi Yu
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ziwei Zhang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiancheng Wang
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Dandan Song
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Quanding Yan
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yang Sun
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiang Xiong
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xianxi Meng
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wenbo Li
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhongjie Yi
- Department of Plastic and Aesthetic (Burn) Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Le D, Gan Y, Mao X, Qu Q, Fan Z, Liu B, Sun P, Zhang J, Hu Z, Miao Y. Hair follicle extraction combined with an expanded scalp flap for facial organ reconstruction. J Plast Reconstr Aesthet Surg 2023; 87:295-302. [PMID: 37925918 DOI: 10.1016/j.bjps.2023.10.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/23/2023] [Accepted: 10/07/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Use of scalp skin for facial organ reconstruction represents a mainstream procedure for organ reconstruction. In most cases, adequate amounts of skin can be obtained by using tissue expanders, but harvesting sufficient scalp tissue in patients with low hairlines is challenging. Hair follicular unit extraction (FUE) is one approach to resolve this problem. With FUE, hair follicles are removed from the scalp skin, which can then be prepared as a donor site to obtain sufficient amounts of hairless skin. OBJECTIVES To evaluate the safety and efficacy of FUE when combined with an expanded scalp flap for facial organ reconstruction. MATERIAL AND METHODS Patients with low hairlines requiring facial organ reconstruction were selected for this study. The area of skin extension and hair removal were determined prior to surgery, a process which was performed in three stages. Stage I consisted of hair follicle removal using the FUE technique at the donor site. Stage II involved expander implantation using water injections. In Stage III facial organ reconstruction was completed. RESULTS With the use of the FUE technique, hair follicles from the donor scalp were thoroughly removed and the donor scalp tissue was successfully expanded. Postoperatively, no evident scar formation at the reconstruction site or contracture of the expanded flap was observed. All patients were satisfied with the outcome of their reconstruction procedure. CONCLUSION FUE provides a means for hair follicle removal from the donor site and can be employed to achieve a safe and effective procedure for facial reconstruction in patients with low hairlines.
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Affiliation(s)
- Demengjie Le
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China
| | - Yuyang Gan
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China
| | - Xiaoyan Mao
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China
| | - Qian Qu
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China
| | - Zhexiang Fan
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China
| | - Bingcheng Liu
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China
| | - Pingping Sun
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China
| | - Jiaxian Zhang
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China
| | - Zhiqi Hu
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China.
| | - Yong Miao
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital Southern Medical University, 1838 Guangzhou North Road, Guangzhou, Guangdong, People's Republic of China.
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Rohrich RJ, Novak M, Chiodo M, Lisiecki J, Savetsky I, Cason R. Beyond Alar Base Resection: Contouring of the Alar Rim and Base. Plast Reconstr Surg 2023; 152:1236-1245. [PMID: 37224414 DOI: 10.1097/prs.0000000000010749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
SUMMARY Alar base surgery is approached with hesitancy and is often avoided by many surgeons because of inexperience and a lack of understanding. However, with a thorough knowledge of the anatomy and dynamic nature of the lower third of the nose, alar base resection can achieve favorable and reproducible results. Beyond correcting alar flare, an appropriately diagnosed and performed alar base procedure serves to contour both the alar rim and the alar base. The following article presents a case series of 436 consecutive rhinoplasties from a single surgeon, 214 of which underwent alar base surgery. The outcomes demonstrate that the procedure is safe and yields desirable results without a single revision being required. As the third in a series of three articles on alar base surgery by the senior author (R.J.R.), this article unifies the management of the alar base. An intuitive approach to the classification and management of alar flare and the implications of alar base surgery on contouring of the alar base and alar rim is presented. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Taylor CB. Evaluation of the Patient with Nasal Obstruction. Facial Plast Surg 2023; 39:590-594. [PMID: 37402402 DOI: 10.1055/a-2122-7251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
Patients often present with a complaint of nasal blockage, either primarily, or in conjunction with aesthetic concerns. The evaluation of the patient with nasal obstruction involves a comprehensive history and a detailed physical examination. The nose is an organ in which form and function are inseparable, and as such, examination of the patient with nasal obstruction must focus not only the internal structures that may cause obstruction of the nasal airway, but also the external structure of the nose as it impacts nasal breathing. Detailed facial analysis and a systematic nasal examination will reveal details regarding nasal obstruction due to internal sources such as septal deviation, turbinate hypertrophy, or nasal lining abnormalities, and structural abnormalities such as nasal valve collapse or external nasal deformity. This approach, in categorizing each component of the nasal exam and its findings, allows the surgeon to formulate an appropriate treatment plan that emerges from the details of the examination.
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Affiliation(s)
- Christine B Taylor
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Texas Health San Antonio, San Antonio, Texas
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Mookerjee VG, Alper DP, Almeida MN, Hu KG, Parikh N, Ihnat J, De Baun HM, Alperovich M. Quantitative Analysis of Morphometric Changes in Feminization Rhinoplasty Utilizing a Standardized Forehead-Rhinoplasty Technique. Aesthet Surg J Open Forum 2023; 5:ojad095. [PMID: 38075296 PMCID: PMC10703580 DOI: 10.1093/asjof/ojad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
Background Rhinoplasty is one of the most commonly performed facial gender-affirming surgeries (FGASs) for transgender females, but well-established morphometric parameters describing feminizing nasal changes do not exist. Objectives Describe the author's technique for feminization rhinoplasty, analyze the changes in 3-dimensional nasal anthropomorphic parameters, and describe patient-reported outcomes. Methods Three-dimensional photogrammetric evaluation was performed both preoperatively and postoperatively in transgender female patients who underwent FGAS. Measurements assessed included the nasofrontal angle, nasolabial angle, dorsal height, mid-dorsal width, alar width, nasal tip width, and tip projection. Patients were surveyed preoperatively and postoperatively using the FACE-Q Nose module. Paired t-tests were utilized to assess changes in postoperative measurements and FACE-Q Nose satisfaction scores. Results Twenty patients underwent FGAS during the study period. The average time between surgery and postoperative 3-dimensional images was 13.6 ± 6.8 months. The nasofrontal angle increased by 8.2° (148.0 ± 7.4° to 156.1 ± 6.7°, P < .001) and tip projection increased by 0.017 (0.58 ± 0.03 to 0.60 ± 0.04, P < .01). Dorsal height, mid-dorsal width, and tip width all decreased significantly (P < .05). There were significant improvements in patients' "Satisfaction with Nose," "Satisfaction with Facial Appearance Overall," "Psychological Function," and "Social Function" on FACE-Q. One revision rhinoplasty was performed, and no documented surgical complications were reported. Conclusions There were statistically significant changes in the nasofrontal angle, tip projection, dorsal height, mid-dorsal width, and tip width in patients receiving feminization rhinoplasty. These data may help surgeons with preoperative planning and intraoperative decision making. Level of Evidence 4
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Affiliation(s)
| | | | | | | | | | | | | | - Michael Alperovich
- Corresponding Author: Dr Michael Alperovich, 333 Cedar St, New Haven, CT 06510, USA. E-mail: ; Instagram: @drmikealperovich
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Ali YH, Elbadawy YA, El-Dsoky I, Autifi MA, Elbanooby T, Taha A, Eleowa S, Farahat A, Mohamed SA, Hamza FA. Ligament Preservation in Open Rhinoplasty: Prospective Analysis. Plast Reconstr Surg 2023; 152:540-546. [PMID: 36723632 DOI: 10.1097/prs.0000000000010256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND In the open rhinoplasty technique, the soft tissue and ligaments are vulnerable to injury. Reconstruction of the ligaments is not performed routinely. The authors aimed to assess the effect of preservation of the nasal ligaments (ie, scroll, septocolumellar, and Pitanguy ligaments) in open-approach rhinoplasty. METHODS In this prospective cohort study, 32 patients underwent open rhinoplasty with ligament preservation after receiving precise training on five cadavers. RESULTS All patients had improved aesthetic and functional outcome in the early postoperative period with long-lasting preservation of tip projection and results. No patient needed secondary revision surgery for tip dropping or malrotation. The objective findings and subjective assessments were satisfying for the patients and surgeons. CONCLUSIONS Refinements of nasal surgery have no limits. This study suggests that nasal ligament reconstruction, including of the scroll, septocolumellar, and Pitanguy ligaments, could maintain nasal tip projection and rotation for a long time. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
| | | | | | - Mohamed A Autifi
- Anatomy and Embryology, Al-Azhar University, Faculty of Medicine
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Analysis of Factors Affecting Postoperative Drainage After Comprehensive Rhinoplasty. J Craniofac Surg 2022; 33:e604-e606. [PMID: 35882255 DOI: 10.1097/scs.0000000000008682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/06/2022] [Indexed: 11/27/2022] Open
Abstract
This study aimed to explore and analyze the factors influencing the drainage volume after comprehensive rhinoplasty. The clinical data of 102 patients who underwent comprehensive rhinoplasty at Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from August 2019 to August 2021 were retrospectively analyzed. The effects of age, sex, body mass index, whether an osteotomy was performed, and whether a nasal septum flap was obtained on the indwelling time of the drainage tube after the operation were analyzed by single factor analysis and multiple logistic regression analysis. Age, body mass index, whether it was a primary rhinoplasty, whether an osteotomy was performed, and whether a nasal septum flap was obtained were the influencing factors for drainage time after augmentation rhinoplasty ( P <0.05). Sex had little effect on the drainage time after comprehensive rhinoplasty ( P >0.05). Body mass index, whether an osteotomy was performed and whether a nasal septum flap was obtained were the independent influencing factors for the postoperative drainage time ( P <0.05). For patients with multiple independent influencing factors, individualized management during the perioperative period should be promoted, and reasonable treatment strategies should be formulated, so as to reduce the indwelling time of the drainage tube after the operation.
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Abstract
Requiring both high-level technical skills and artistic sense, rhinoplasty continues to be one of the most challenging procedures in plastic surgery despite its popularity. A thorough preoperative consultation of the rhinoplasty patient forms the foundation of a successful case. During the consultation, the physician should obtain a detailed medical and nasal history, understand the patient's areas of concern, conduct a nasal analysis, and evaluate the patient's candidacy for surgery. This article reviews the key functional, esthetic, and psychosocial considerations that should be taken into account during a preoperative consultation for a rhinoplasty patient.
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Why Primary Rhinoplasty Fails. Plast Reconstr Surg 2021; 148:1021-1027. [PMID: 34705776 DOI: 10.1097/prs.0000000000008494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
SUMMARY Rhinoplasty remains one of the most challenging operations performed by plastic surgeons. The complexity lies in the ability to have a consistent and predictable aesthetic result. The unpredictability is mainly attributable to the interplay of manipulated internal structures and wound healing dynamics. In addition, setting realistic expectations with the patient is essential for achieving high postoperative patient satisfaction. An open rhinoplasty approach enables an accurate and in-depth evaluation and intervention. The authors provide a detailed analysis and discussion on why primary rhinoplasty fails, along with the surgical approach for preventing these failures.
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Harris J, Premaratne ID, Spector JA. Facial Masculinization from Procedures to Payment: A Review. LGBT Health 2021; 8:444-453. [PMID: 34403627 DOI: 10.1089/lgbt.2020.0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As the demand for gender-affirming procedures continues to increase, patients and providers have a greater imperative to understand the current state of facial masculinization. Facial reconstruction for transgender women has been shown to treat gender dysphoria effectively and reduce rates of discrimination and victimization. Although facial masculinization surgery for transgender men is less common, there are multiple surgical and nonsurgical options to supplement the effect of hormone therapy on facial appearance, including but not limited to: receding the hair line, flattening the forehead, expanding the supraorbital ridge, increasing the dorsal nasal projection, squaring the jaw, and augmenting the chin. This review aims to summarize these techniques for providers who wish to inform transgender male patients about their options and discuss them in the context of patient satisfaction and availability of insurance coverage.
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Affiliation(s)
- Jason Harris
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Ishani D Premaratne
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Jason A Spector
- Laboratory of Bioregenerative Medicine and Surgery, Division of Plastic Surgery, Weill Cornell Medical College, New York, New York, USA.,Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, USA
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