male revision rhinoplasty surgery by dr paul s nassif - incontinence dermatitis and evaluating and

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male revision rhinoplasty surgery by dr. paul s. nassif - incontinence dermatitis and evaluating and using skin care products

by:NOX BELLCOW     2019-11-22
male revision rhinoplasty surgery by dr. paul s. nassif  -  incontinence dermatitis and evaluating and using skin care products
Correction rhinoplasty for men is the most difficult and challenging surgery for facial plastic surgeons.
It takes years to improve the operation with a three-dimensional nose, perhaps mastering.
During rhinoplasty, the slight rhinoplasty we do today may result in severe postoperative deformity three years later.
Many of us have been told that positive cartilage removal is a process in the past.
Today's concept is "less is more ".
The majority of residents and the fellowship, as well as our national conference, are teaching less cartilage removal, cartilage repositioning, camouflage techniques, structural transplants, and stitching techniques.
When initial rhinoplasty is performed, the need for future rhinoplasty is becoming more and more common.
In general, rhinoplasty is more complex for men than for women, as men may have higher or unrealistic expectations and often thick nose skin, which is harder to re-
The support of the tip of the nose is thinner than the nose.
In the first rhinoplasty of men, the key to preventing complications is preoperative
Diagnosis of potential anatomical and functional abnormalities.
For example, the patient wants the back hump to shrink and you can identify the short nasal bone, thick skin and long central vault.
Your thorough assessment will warn you that it is possible for this patient to be semi-fixed from the upper side of the nasal bone cartilage (inverted)
V deformity) and internal valve collapse after fracture.
For male patients undergoing revision rhinoplasty, a detailed anatomical and functional assessment of the nose was initially performed, and the presence of postoperative nasal deformity and nasal obstruction sites were then recorded.
After finding problems and potential complications, create an ordinary surgical plan while studying the preoperative photos, and be prepared to use everything in the surgical equipment, because the preoperative plan for your nasal surgery revision usually changes during the procedure.
Here is the algorithm for my rhinoplasty correction consultation.
At the time of the appointment, the patient was asked to carry a copy of their medical record and surgical report for rhinoplasty or surgery, along with a photo of their local nose.
Review notes and photos when potential patients discuss surgery with your patient care coordinator.
This will give you a start to identifying the problem, assuming it exists.
Next, a detailed historical record is made while listening very carefully to the patient's wishes.
Does he have realistic expectations?
This is by far the most important detail that savvy surgeons need to get from history.
What is the patient not satisfied with the squeezed tip or Polly? beak deformity?
Also, listen to the patient to see if there is a negative comment or if the patient is seeking a lawsuit against a former surgeon.
If this is the case, you may need to think twice before undergoing a revision rhinoplasty for this patient.
If the male patient is not satisfied with the results of your surgery, it is very likely that he will say unfriendly things to you in the subsequent surgeon's office.
Does he fit Simon's profile (single, immature, male, obsessive-compulsive, and narcissistic )?
If so, please be careful as it is difficult for these patients to please and to bring a lawsuit.
In the first five minutes of your medical history, savvy surgeons should know if the patient is a good candidate for a refurbished operation.
Improper patient selection can lead to unhappy patients and surgeons.
Another important detail is to determine if the patient has a nasal congestion.
The incidence of nasal congestion after rhinoplasty was about 10%.
1 determine whether there is nasal congestion before surgery.
If it is a blockage caused by surgery, some questions need to be answered.
Did the patient perform rhinoplasty?
Let the patient point out where the obstacle is.
Is it static or dynamic?
Presented with normal or profound inspiration?
What relieved and aggravated the nasal congestion?
What is the characteristic of nasal congestion?
Did you have an interval operation?
A medical examination was then conducted.
For physical examination, I use a detailed nose analysis worksheet to perform a detailed visual and tactile assessment of the nose.
Touch your nose with fingers that don't wear gloves.
Check bone and cartilage bones, tips and skin
Soft tissue cladding features in frontal, oblique, side view, and base view.
For bone back, examine the presence of bone resection, open roof deformity or rocker deformity and the humps belowor over-resection.
If the hump is reduced to insufficient, first check the number of deep bases and/or insufficient
Prominent nose tip, scratch, micro-deformity.
Looking for an abnormality in the middle vault, such as a narrow middle vault, an inverted vault
Deformity or deficiency
Resection of the cartilage back (Polly-Abnormal mouth ).
For the tip, check the tip projection, rotation, support, nose wing and small column retracement, excessive
Positive reduction of the bottom of the nose wing, and features of the lower foot such as excessive bending
Resection, head-side orientation or bossa formation. Over-
Resection of the lower lateral cartilage complex in men --
The soft tissue cladding causes the tip of the nose to sag and subsequent nasal congestion.
The cartilage back and tip of the nose of the oblique can represent the oblique diaphragm.
This is just a partial anatomical problem that the surgeon needs to identify in the nasal analysis.
For male patients with nasal congestion, observe his normal and profound inspiration in the frontal and basal views.
Typically, diagnosis is easily identified
Nose wing, nose wing and/or edge collapse (slit-
In a static or dynamic state, such as nostrils.
External valve collapse (sublateral cartilage pathology) can be evaluated with a soft end of a cotton swab while blocking the reverse-Side nostrils
The cotton swab enhances the area of the obstacle, whether it is the edge of the nose, the lower foot or the upperalar region.
See if patients with nasal tip sagging relieve nasal congestion by lifting the tip of the nose.
Perform a Cottle action (pull sideways on the cheek) to check if the internal valve collapses.
Although this test is generally not
Specifically, the excess caused by internal nasal valve disease
It is possible to diagnose the narrow angle between the nasal wing extrusion or the upper lateral cartilage and the diaphragm.
On the base view, check the internal and lateral feet of the lower leg to determine if they impact the nasal airway.
After thorough external nasal assessment, an internal nasal examination was subsequently performed.
At the very least, a rhinoplasty examination is performed in the case of local resection and non-resection.
Nasal endoscopy and nasal measurement may be useful in some cases.
To evaluate nasal perforation, persistent deviation, and any residual cartilage residue used for transplant.
Other reasons for nasal congestion are: hyperfat of the lower nose, adhesion between the external nasal wall and the compartment, nasal mass and abnormal middle nose (concha bullosa ).
When you check the patient, create a list of psychological problems with solutions and then record them on your nose analysis sheet, such as: 1.
External valve collapse caused by excessive
Resection of the lower lateral crura, using conchal cartilage, 2. open rhinoplasty with the nasal wing batten graft.
Narrow middle vault and collapse of secondary internal nasal valve above
Nose wing extrusion with medium inspiration with bilateral sling graft and super
The nasal wing batten graft using conchal cartilage, and 3.
The two sides of the nose are retracted, and the two sides of the conchal composite graft are planned.
If structural grafting is necessary, decide what material can be used.
In addition to harvesting techniques, a thorough understanding of the type of autologous (compartment, conchal, rib cartilage, deep temporary fascia and skull) or the same plastic transplant is required.
This is just an initial plan when you create the algorithm.
Guaranteed, it will change as you get closer to the surgery.
Computer deformation can be very useful if the patient is told that the final image does not guarantee the result.
However, despite proper notice and consent, it is reported that the patient has filed a lawsuit against a result different from that produced by the computer imagers.
Computer imaging can provide clues to the patient's expectations.
When a surgeon produces a conservative image and the patient wishes to change it completely, unrealistic expectations can be determined.
Therefore, computer imaging can be a powerful tool for evaluating patients with surgery.
I am unable to count the number of male patients I refuse to undergo primary and renovation operations because they can only determine unrealistic expectations through computer deformation.
Another use of the computer image is to use it as a target for surgery.
Take photos of preoperative and computer images to the operating room.
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