The alar cartilage morselizer.
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Biomedical subjects
Publications and source records attributed to F F Rubin.
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Modification and refinement of the nasal tip has long been regarded as the most difficult and complicated procedure in rhinoplasty. The various procedures and approaches to this surgery have been characterized by removal of increasing amounts of lateral crus in an effort to develop greater definition of the tip. This has resulted in a number of iatrogenic deformities. In addition, it has resulted in undesirable and uncontrolled amounts of rotation and retrodisplacement. A technique with some variations that I have used for a number of years serves to overcome most of these problems while providing excellent definition to the tip. This method, with some variations, leaves 90% to 100% of the lower lateral cartilages of the nose that serves as a lateral strut. This limits the retrodisplacement and rotation that takes place when scar tissue replaces the excised lower lateral cartilages of the nose.
Nasal profiles are altered in almost every rhinoplasty operation. Often neglected in diagnosis and surgery are alterations in profiles of the cheeks and upper lip that should be made at the same time. We show aesthetic effects produced by alterations in these structures and describe how we measure and record the adjustment. A few examples of results are presented to indicate the techniques used and the importance of including changes in profiles of the cheeks and upper lip in cosmetic rhinoplastic diagnosis and treatment.
Because of difficulties in making accurate measurements from before and after photographs, we have devised measuring techniques not dependent upon exact reduplication of photographic circumstances before, during, and after surgery. Measuring devices contacting the head of the patient in specified ways are described. They allow simple and exact reduplication so that measurements made at different times can be compared. Lengths of nose and of columella and actual projection of brow, nasofrontal angle, rhinion, supratip region, the tip itself, and of the columella-labial junction can be measured. Tip rotation, cephalic or caudal, can be determined and quantitated. The devices and techniques for using them are described. We believe that employment of the suggested measuring techniques will allow better reporting of rhinoplastic methods and results should significantly increase our understanding of this complex surgical procedure.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.