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Biomedical subjects

G Aiach

Publications and source records attributed to G Aiach.

17 recordsLinked to original sources

[Rhinoplasty].

The goal of rhinoplasty should not be necessarily a small nose but a nose which is well balanced with the face and fits with the individual. Increasing number of patients is linked with improvement of the techniques and it is frequent to see patients asking for correction of minor defects. Sequelae of rhinoplasty are still frequent but less severe, and even if their correction is difficult, it is possible in most cases, thanks to the use of cartilage grafts and external approach.

Female

Treatment of over-reduction of the nose and subsequent deformities.

Failures after rhinoplasty are the result of both technical mistakes and of errors of judgement. One of the most common errors is resection of too much tissue from the components of the nose: the dorsum, alar cartilages, or septum. Such deformities may have both cosmetic and functional effects. The defects that most commonly make a nose look unnatural are: a shallow nasofrontal angle, a nose that has been shortened too much, an over-reduced dorsum which emphasises a parrot's beak deformity, and a round nasal tip with a short interdomal length that lacks definition. The purpose of this paper is to describe the most common deformities associated with excessive resection of the nose, and to suggest the appropriate procedures for correcting the defects. Grafting is usually necessary. We will deal first with deformities of the dorsum and septum and then of the nasal base, but it must be borne in mind that a defect in one area is likely to affect the other areas because they are interrelated-for example, over-resection of the dorsum may also effect the tip of the nose. In addition, not all deformities are the result of excessive reduction; some may result from inadequate resection.

Bone Transplantation

[Recent developments in esthetic rhinoplasty].

Over the last two decades, the concepts of cosmetic rhinoplasty have advanced, essentially due to the influence of J. Sheen. The importance of the anatomy of osteocartilaginous structures, their dynamic role, and the repercussions of their modification on the external shape has led to a more conservative surgery. Innovations have essentially concerned nose tip surgery and cartilage grafts. The revival of external approach and its popularity constituted the second major development; this can be explained by the direct, visualisation of cartilaginous structures and by the desire or necessity to preserve or reconstruct these structures. The indications for cartilage grafts have become more frequent and graft techniques have been developed and refined. The difficulties encountered in the use of autologous grafts have favoured the development of many new implants. Parietal cranial grafts occupy an increasingly important place in the indications for nasal bone grafts.

Adult

[Mini-forum: rhinoplasty by external approach. External or endonasal approach for rhinoplasty?].

There appears to be a renewed interests in the external approach to rhinoplasty, first described 60 years ago, despite the external columellar incision, due to the excellent exposure of the cartilaginous structures provided by this approach. Progress has been made in rhinoplasty. Cartilage grafts are much more widely used than in the past and surgeons try to reconstruct a normal anatomy of the skeleton, which has become easier with this approach. However, the closed approach has demonstrated its efficacy for a long time and allows correction of a large range of deformities. The open rhinoplasty should not be the standard procedure and its indications should only be based on limitations of the closed approach. The external procedure is particularly indicated in some difficult cases of nasal tip surgery and secondary rhinoplasty.

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