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Filler rhinoplasty based on anatomy: The dual plane technique.

ABSTRACT: Filler rhinoplasty is susceptible to spreading because of the way the nose protrudes away from the face. Often, the well-defined appearance immediately after the procedure is poorly maintained, and the nasion area develops a bulbous appearance. Therefore, I developed a "dual plane technique" to prevent spreading and to maintain the desired shape of the filler rhinoplasty. Dual plane injections were administered in 96 patients. Based on the anatomy of the nose, a highly elastic filler was injected in the deep fat layer and a moderately elastic filler was injected in the superficial fat compartments. The retrograde linear threading technique was used to inject the fillers to prevent mixing with each other. Afterwards, the highly elastic hyaluronic acid filler was injected from the anterior nasal spine into the supracartilaginous layer by a retrograde linear threading technique. All patients were followed up for at least 3 months, during which time there were no major complications and aesthetic satisfaction was high. The dual plane technique is an injection technique based on the anatomical base. Different types of filler can be used according to the plane and filler rheology to obtain an aesthetically pleasing result.

SUBMITTER: Jung GS

PROVIDER: S-EPMC7061673 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Filler rhinoplasty based on anatomy: The dual plane technique.

Jung Gyu Sik GS

JPRAS open 20190417

Filler rhinoplasty is susceptible to spreading because of the way the nose protrudes away from the face. Often, the well-defined appearance immediately after the procedure is poorly maintained, and the nasion area develops a bulbous appearance. Therefore, I developed a "dual plane technique" to prevent spreading and to maintain the desired shape of the filler rhinoplasty. Dual plane injections were administered in 96 patients. Based on the anatomy of the nose, a highly elastic filler was injecte ...[more]

PMID: 32158877

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Project description:ImportancePostoperative pain at the donor site is a common morbidity following autologous costal cartilage grafting.ObjectiveTo evaluate postoperative pain at the donor site after the use of a muscle-sparing costal cartilage harvesting technique compared with a muscle-cutting technique using electrocautery.Design, setting, and participantsDesigned as a controlled trial without randomization, this prospective, comparative cohort study was conducted between January 1, 2016, and March 31, 2017. Participants included 20 patients who underwent rhinoplasty for various cosmetic and functional complaints from January 1, 2016, to February 28, 2017. Of the 20 patients, 1 was excluded owing to an infection that developed on postoperative day (POD) 7. Patients were grouped by the rib harvesting technique used that was either a muscle-sparing technique (n = 11) or a muscle-cutting technique (n = 8). Skin incisions for both groups were carried out with a blade. Transection of muscle fascia and muscle fibers was performed with monopolar electrocautery in the muscle-cutting technique group. Blunt dissection with a hemostat was performed in the muscle-sparing technique group. All other surgical techniques were identical.Main outcomes and measuresPostoperative pain was assessed with visual analog scale scores for resting pain and movement pain. Eight pain measurements were noted at the sixth postoperative hour and on PODs 1, 2, 3, 7, 15, 30, and 45. During the hospital stay, the postoperative need for analgesics was recorded daily as the number of analgesic infusion vials used.ResultsThe 19 patients in the study included 11 women and 8 men whose mean age (SD) was 33.2 (10.3) years The mean (SD) visual pain analog scale scores for resting pain and movement pain were consistently higher in the muscle-cutting technique group than in the muscle-sparing technique group. This difference was statistically significant on PODs 2, 3, and 15 for resting pain and on PODs 2, 3, 7, 15, 30, and 45 for movement pain. The mean postoperative need for analgesic infusion vials during hospital stay was higher in the muscle-cutting technique group, and the difference was statistically significant on POD 2 (1.9 [0.6] vials vs 1.0 [0.9] vials; P = .02).Conclusions and relevanceBoth resting and movement pain at the donor site was significantly reduced in the muscle-sparing technique group during the postoperative period, findings that align with anecdotal reports in the literature. Routine use of the muscle-sparing technique in autologous costal cartilage harvesting is recommended to reduce postoperative pain.Level of evidence2.

Dataset Information

Filler rhinoplasty based on anatomy: The dual plane technique.

Publications

Filler rhinoplasty based on anatomy: The dual plane technique.

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