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Backgroundobjective: Post-oncological nasal reconstruction presents both aesthetic and functional challenges. While established methods exist for quantitatively evaluating functional results following surgery, equivalent systems for assessing aesthetic outcomes are lacking. Three-dimensional (3D) photogrammetry, already used in maxillofacial and orthodontic surgery for aesthetic evaluation, overcomes some limitations of traditional methods like direct anthropometry. However, its applicability in oncological facial reconstruction has not yet been explored. In our study, we applied the 3dMDtrio™ system for the quantitative analysis of line and surface modifications following nasal reconstruction., Methods: We conducted a prospective observational study enrolling patients with skin neoplasms located on the nose undergoing surgical excision and reconstruction. Using the 3dMDtrio™ system, we measured the dimensions and projections of nasal surfaces and the positions of specific landmarks before and after surgery. The surface measurements were then correlated with aesthetic evaluations performed by three plastic surgeons, not involved in the procedure, using a 5-point Likert scale., Results: We included 33 patients with a mean age of 71 years, ranging from 40 to 94. We obtained complete documentation of all postoperative measurements for 21 patients. We observed significant changes in the positions of the landmarks post-surgery, limited to the right ala and nasion. The average nasal surface area was 4674.41 mm 2  ± 477.24 mm 2 before surgery and 4667.95 mm 2  ± 474.12 mm 2 after surgery, with no significant discrepancies. The evaluation using the Likert scale revealed an average score of 3.04 ± 0.48, with a significant negative correlation to the measured surface changes., Conclusion: Our findings suggest that 3D photogrammetry can be considered a valid method for objectively assessing volumetric changes associated with post-oncological nasal reconstructive surgery., Competing Interests: Declaration of competing interest The authors have no financial or personal relationships, activities, or interests to disclose in relation to the content of this article., (Copyright © 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Published by Elsevier B.V. All rights reserved.)

Patients undergoing revision rhinoplasty can show complex tip deformities such as asymmetry, dome angulation with cartilage interruption, alar pinch and retraction, and underprojection. When these defects are present at the same time, often multiple cartilage grafts are needed to restore a pleasing tip and functional external nasal valve. This study reports our experience with the rainbow graft, a previously described technique that can repair with a single cartilage graft the above-mentioned defects. We performed a retrospective review of 21 patients who had undergone revision rhinoplasty between 2006 and 2017 employing the rainbow graft technique to correct complex tip deformities. The presence of tip deformities such as asymmetry, dome angulation with cartilage interruption, alar pinch, alar retraction, and under/overprojection was recorded preoperatively and postoperatively. Complete photographic documentation was done, and Rhinoplasty Outcome Evaluation (ROE) questionnaire was administered to the patients. Five patients were male and 16 were females. Mean age of patients was 40 ± 7.6 years. Follow-up ranged from 1 to 12 years, mean 5 ± 3 years. Eight patients had undergone one rhinoplasty, 10 patients had undergone two, and three patients had undergone three. Before surgery, all patients showed asymmetry, 20 dome angulation, 19 alar pinch, and 18 retraction. Eight showed tip overprojection, six underprojection, and seven no alteration of tip projection. The mean ROE score was 20.23 ± 7.37. After surgery, two patients showed persistent asymmetry, none had dome angulation, one alar pinch, and two alar retraction. Projection was corrected in every patient. We observed no case of graft infection, malposition, or resorption, and corrections achieved remained stable during follow-up. Mean postoperative ROE score was 80.75 ± 6.24. Its improvement was statistically significant (p < 0.001). The rainbow graft is a safe and effective technique in revision rhinoplasty indicated for the total restoration of nasal tip appearance in the presence of complex secondary deformities., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to disclose., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Revision rhinoplasties are extremely difficult to perform even for the surgeons mastering nasal surgery. In fact, they must be skilled at adapting surgical strategies to the anatomical changes induced by primary rhinoplasty.We herein describe an original technique using an auricular cartilage graft after 6 revision rhinoplasties.The aforementioned graft succeeded in improving tip support, correct external nasal valve dysfunction and alar pinch, and providing tip definition, projection, and ptosis.In our opinion, rainbow graft is a safe approach in case of severe nasal structural deficiencies, improving both the functional and esthetic results in revision rhinoplasties.

The thinning of the overlying nasal skin and nasal SMAS layer and the variations in nasal bones consistency increase the risk of showing dorsal contour irregularities after osteotomies of this site.The authors present their experience with combined nasal dorsal osteotomies and insertion of a SMAS strip graft, harvested during facelift procedure in 6 aging patients.Postoperative follow-up time ranged from 1 year to 7 years and showed excellent outcomes: no infection, graft migration, or reabsorption was detected.Due to the ease of execution of the procedure and taking into account this graft as an ideal soft-tissue augmentation composed by fat, muscle, and fascia, the SMAS strip autograft represents another viable option for nasal dorsum contouring in the patient presenting also for rhythidectomy.

Unlabelled: A proper bloodless field and coagulation profile represent essential elements for performing a safe, effective, and fast rhinoplasty. However, some particular conditions among patients with a high thromboembolic risk for congenital thrombophilia require antithrombotic prophylaxis using low-molecular-weight heparin. To date, the literature contains no particular indication for the management of patients undergoing rhinoseptoplasty while receiving anticoagulant therapy. The authors report their experience managing a 36-year-old man who underwent aesthetic rhinoseptoplasty while at the same time carrying a heterozygous mutation (G20210A) of prothrombin and a homozygous mutation of methylenetetrahydrofolate reductase (C677T). Special attention must be paid to balancing the prevention and reduction of thrombotic risk for excessive anticoagulation, which would make surgery unsafe and difficult to perform., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article.

Revision rhinoplasty is a complex aesthetic and reconstructive procedure in which both functional and cosmetic principles must be considered in the planning of an appropriate operation. Different techniques must be modified according to the specific defects. The modifications may vary from simple integration of a previous poorly performed surgery to complex grafting of homologous or heterologous material. The authors report their experience with 311 cases of revision rhinoplasty.

Background: Osteotomy represents a crucial step in structural rhinoplasty; however, there is not a unique approach accepted. Double lateral osteotomy has proven to be effective in the long-term correction of a deviated nose. In this series, we evaluated its aesthetic value also in non-deviated cases. Materials and Methods: 864 patients who underwent primary structural rhinoplasty from 2012 to 2020 were divided into four groups. Group A and B included patients with a crooked nose treated with asymmetrical double osteotomy and bilateral double osteotomy, respectively. Patients who did not present nasal deviation were divided into group C, including cases treated with bilateral single osteotomy, and group D, including patients who underwent bilateral double osteotomy. Postoperative evaluations were performed by three independent plastic surgeons blinded to the surgical technique. Patient's satisfaction was assessed through the FACE-Q rhinoplasty module. Results: FACE-Q scores reported a satisfaction rate higher than 30% for every item in all groups; however, group B and group D showed statistically higher satisfaction (p < 0.01). According to the evaluations performed by physicians, group B and group D showed the most satisfactory outcomes (p < 0.01). Conclusions: bilateral double osteotomies represent a significant aesthetic refinement in structural rhinoplasty, not only in crooked noses but also in non-deviated cases, since the reduction in the width of the nose is an aesthetical aspect very appreciated by patients. [ABSTRACT FROM AUTHOR]