Proper local anesthesia is critical to allow atraumatic dissection with minimal bleeding and edema. A total volume of less than 3 ml of 1% lidocaine with 1:100,000 epinephrine is typically used to attain anesthesia for rhinoplasty alone. When performing septorhinoplasty, as much as 10 nil of local anesthetic may be used. The anesthetic is al-… [Read More]
Rhinoplasty Fundamentals
Rhinoplasty Analysis
Development of an operative plan that will achieve the desired outcome requires an understanding of the patient’s wishes and selection of appropriate surgical maneuvers to effect the proposed changes. The surgeon must be able to identify anatomic constraints that will limit the ability to change contour (thick skin, weak cartilages, etc.). Experience with rhinoplasty over… [Read More]
The Rhinoplasty Consult- Patient Evaluation
Patients seeking rhinoplasty span a wide range of ages and ethnicities. In addition, they may have an equally wide range of desired outcomes from the procedure. The initial rhinoplasty consultation is an opportunity for the surgeon to assess the patient. This assessment includes both that of the physical and psychological condition of the individual. In… [Read More]
Open-tip Rhinoplasty: Exposure, Step By Step
1. INTRODUCTION History of rhinoplasty comes from many centuries ago, most probably from ancient cultures in Egypt. One of the most important steps in modern open-tip rhinoplasty history was taken in 1921 by Rethi, from Budapest, which described an external approach to expose alar cartilages and nasal dorsum only through a unique high columellar skin… [Read More]
Anatomy, Incisions and Approaches: Open and Closed Rhinoplasty
Introduction In the modern era of rhinoplasty, the introduction of external rhinoplasty was greeted by enthusiastic advocates and also met with spirited opposition. Over time, however, the tenor of this debate has become more ecumenical. Most surgeons now recognize the broad utility of both endonasal and external approaches. Most understand that there are situations when… [Read More]