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Rhinoplasty: Case Example 4- Augmentation with Dorsal Implant Graft
A 35-year-old female presented for revision rhinoplasty requesting reduction of her “large” nose.
Analysis of the nasal profile revealed an inadequate height of the bony dorsum including the radix. This inadequacy was accentuated by excessive projection of the cartilagenous dorsum and nasal tip. The surgeon performing the original rhinoplasty had oversected the cephalic portion of the dorsum while failing to address the over-projected nasal tip and caudal dorsum.
Augmentation of the radix and cephalic dorsum was achieved with an alloplastic (Gore-Tex) extended radix implant. The caudal dorsum was then aligned to the level of the implant, and the tip was retro displaced. Two year postoperative views demonstrate a more ideal nasal profile (Fig. 10). The radix and dorsal implant reduced the nasofacial angle, lengthened the nose, and restored dorsal height.
Figure 10A: Over resected cephalic nasal dorsum. Under projected radix. Over projected caudal dorsum. Cephalic dorsum and radix augmented using alloplastic (Gore-Tex) extended radix implant.
Figure 10 B-G: Preoperative and 1.5 years postoperative photographs.
REFERENCES
1. Byrd, S and Hobar, C. Dimensional Rhinoplasty. Plast. Reconstru. Surgr.
2. Daniel RK. Rhinoplasty. 1993
3. Crumley RL, Lancer R. Quantitative analysis of nasal tip projection. Laryngoscope 1988;98:202-208.
4. Powell N, Humphreys B. Proportions of the Aesthetic Face. New York: Thieme-Stratton, 1984.
5. Sheen J.H. and Sheen A.P. Aesthetic Rhinoplasty (2nd ed) St Louis: Mosby, 1987
6. Guyron, B. Precision Rhinoplasty. Part II: Prediction. Plast Reconstr. Surg. 81:500, 1988
7. Johnson CM Jr, Alsarraf R. The radix graft in cosmetic rhinoplasty. Arch Facial Plast Surg. 2001 Apr-Jun;3(2):120-1
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For more information on Rhinoplasty, please visit the primary rhinoplasty section
For more information on Revision Rhinoplasty, please visit the revision rhinoplasty section