Rhinoplasty W hen the nose appears pleasing, there is not only an optimal congruity between the d... more Rhinoplasty W hen the nose appears pleasing, there is not only an optimal congruity between the different proportions of the nose, but also harmony between the nose and the rest of the facial features. One of the most displeasing disharmonies of the nose is an elongated anterior nose, or a nose with tip ptosis. In this article, we will define the the drooping, ptotic nose. We will also discuss contributing factors leading to nasal tip ptosis and present our management algorithm.
For decades, plastic surgeons have been aware of the powerful relationship between the nose and c... more For decades, plastic surgeons have been aware of the powerful relationship between the nose and chin in facial aesthetics. (As a clinical example, chin augmentation is performed in 12% of all primary cosmetic rhinoplasty patients in the senior author's [R.K.D.] practice.) Yet, there has not been an equal awareness of the dramatic interplay between the nose and brows in both primary and secondary rhinoplasty patients. During the past 3 years, we have performed a variety of brow modification procedures in association with nasal surgery. The evolution of our approach has been driven by 2 groups of patients: (1) primary patients with a full radix, illdefined nasion, and low medial brows and (2) secondary patients who complain that their nose still looks "heavy" following a primary rhinoplasty. Solving these problems required development of a new set of aesthetics that integrates the nasal-glabellar-orbital region using the polygon concept. The surgical solution represented an adaptation of the standard endoscopic forehead lift (EFL) for older patients and a simpler central browlift (CBL) for younger patients.
Rhinoplasty W hen the nose appears pleasing, there is not only an optimal congruity between the d... more Rhinoplasty W hen the nose appears pleasing, there is not only an optimal congruity between the different proportions of the nose, but also harmony between the nose and the rest of the facial features. One of the most displeasing disharmonies of the nose is an elongated anterior nose, or a nose with tip ptosis. In this article, we will define the the drooping, ptotic nose. We will also discuss contributing factors leading to nasal tip ptosis and present our management algorithm.
For decades, plastic surgeons have been aware of the powerful relationship between the nose and c... more For decades, plastic surgeons have been aware of the powerful relationship between the nose and chin in facial aesthetics. (As a clinical example, chin augmentation is performed in 12% of all primary cosmetic rhinoplasty patients in the senior author's [R.K.D.] practice.) Yet, there has not been an equal awareness of the dramatic interplay between the nose and brows in both primary and secondary rhinoplasty patients. During the past 3 years, we have performed a variety of brow modification procedures in association with nasal surgery. The evolution of our approach has been driven by 2 groups of patients: (1) primary patients with a full radix, illdefined nasion, and low medial brows and (2) secondary patients who complain that their nose still looks "heavy" following a primary rhinoplasty. Solving these problems required development of a new set of aesthetics that integrates the nasal-glabellar-orbital region using the polygon concept. The surgical solution represented an adaptation of the standard endoscopic forehead lift (EFL) for older patients and a simpler central browlift (CBL) for younger patients.
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