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Updated Dynamics of Rhinoplasty: A Review of the Literature and Comprehensive List of the Findings

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  • Rhinoplasty
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Abstract

Background

The cardinal reason accounting for the complexity of rhinoplasty is that each maneuver during this operation has both intended and unintended effects. The purpose of this report is to review the literature and update the dynamics of rhinoplasty.

Methods

PubMed searches were conducted for “rhinoplasty dynamics” as well for keywords associated with each specific rhinoplasty maneuver. Titles were evaluated for relevance, and duplicates were consolidated with years of publication 1991 to 2019. Article types include case series (retrospective and prospective), cohort studies, and review articles.

Results

Beginning with the radix, its reduction apparently elongates the nose and widens the intercanthal space, while radix augmentation creates the opposite illusions. In a similar manner, dorsal hump reduction widens both the nose and intercanthal space. Nasal tip dynamics focus on the aftermath of changes to tip projection, width, and rotational position. Resection of the upper lateral cartilages can cephalically rotate the tip and reduce tip width. Manipulation of the footplates of the medial crura primarily influences the columella but can also affect tip projection. Placement of a columellar strut firmly establishes tip position. Placement of alar rim grafts advances the ala caudally, widens the nostrils, and elongates the short nostril. Alar base reduction can create the illusion of increased tip projection. Augmentation and reduction in the anterior nasal spine influence tip projection, upper lip length, and the nasolabial angle.

Conclusions

As rhinoplasty techniques continue to evolve, surgeons undertaking this operation must continue to reassess the dynamics of various maneuvers.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Authors and Affiliations

  1. Case Western Reserve University School of Medicine, 9501 Euclid Ave, Cleveland, OH, 44106, USA

    Thomas Yu Xia, Ayesha Punjabi, Jessica Hyejin Oh & Corinne Wee

  2. Department of Plastic and Reconstructive Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA

    Ayesha Punjabi & Corinne Wee

  3. Zeeba Surgery Center, 29017 Cedar Road Lyndhurst, Cleveland, OH, 44124, USA

    Bahman Guyuron

Authors
  1. Thomas Yu Xia
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  2. Ayesha Punjabi
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  3. Jessica Hyejin Oh
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  4. Corinne Wee
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  5. Bahman Guyuron
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Correspondence to Bahman Guyuron.

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Dr. Guyuron reports financial connection to Elsevier, Thieme, Innovative Medical Equipment, and various associations, outside the submitted work.

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Xia, T.Y., Punjabi, A., Oh, J.H. et al. Updated Dynamics of Rhinoplasty: A Review of the Literature and Comprehensive List of the Findings. Aesth Plast Surg 44, 904–909 (2020). https://doi.org/10.1007/s00266-020-01619-z

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  • DOI: https://doi.org/10.1007/s00266-020-01619-z

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