Rinoplastia - Rinomodelación || Nasal chin-deformity
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Rinoplastia - Rinomodelación || Nasal chin-deformity
- 4. PURPOSE Determine the frequency of appearance of Nasal Chin Deformity and type of nasal and chin anomaly most commonly related to each other www.clinicabenarroch.com
- 6. PATIENT DISTRIBUTION SEX www.clinicabenarroch.com SEX NUMBER % MALE 51 14.70 FEMALE 293 85.30 TOTAL 344 100
- 7. PATIENT DISTRIBUTION AGE www.clinicabenarroch.com AGE NUMBER % 15 – 20 138 40.23 21 – 30 163 47.29 31 – 40 28 8.05 41 – 50 8 2.47 > 50 7 2.05 TOTAL 344 100
- 10. PATIENT DISTRIBUTION SURGICAL PROCEDURE GROUPS www.clinicabenarroch.com GROUPS PROCEDURE NUMBER % I RHINOPLASTY 138 40.01 II GENIOPLASTY 113 32.94 III RHINOGENIOPLASTY 93 27.05 TOTAL 344 100
- 12. BASIC CLOSED RHINOPLASTY www.clinicabenarroch.com
- 13. HORIZONTAL OSTEOTOMY OF THE CHIN www.clinicabenarroch.com
- 32. DISCUSION GROUP III www.clinicabenarroch.com GROUPS PROCEDURE NUMBER % I RHINOPLASTY 138 40.01 II GENIOPLASTY 113 32.94 III RHINOGENIOPLASTY 93 27.05 TOTAL 344 100
- 33. SURGICAL PROCEDURES RHINOPLASTY GROUP III www.clinicabenarroch.com PROCEDURE NUMBER % BASIC RHINOPLASTY 83 89.6 NASAL WITDH AISOLATED 7 7.3 NASAL TIP AISOLATED 3 3.1 TOTAL 93 100
- 34. GROUP III BASIC RHINOPLASTY N 83 www.clinicabenarroch.com PROCEDURES NUMBER % Cephalic trim 59 71.1 Alar suturing 39 46..9 Tip grafting 40 48.2 Hump reduction 79 95.1 Osteotomies 75 90.4 Base surgery 54 65.7
- 35. HORIZONTAL OSTEOTOMY OF THE CHIN GROUP III www.clinicabenarroch.com DISPLACEMENT NUMBER % ANTERIOR 87 93.6 TRANSVERSAL 4 4.4 VERTICAL 1 1.1 POSTERIOR 1 0.9 TOTAL 93 100
- 38. THANK YOU Dr. Samuel Benarroch Mahfoda MD, DDS ,MS Oral & Maxillofacial Surgery Assistant Professor Oral & Maxillofacial Surgery Residency Program Woodhull Medical Center. New York Hospital Magallanes de Catia. Caracas NASAL CHIN DEFORMITY www.clinicabenarroch.com
Notas do Editor
- Esthetic ideals and proportional norms of the human face including the complex Nose-Lips-Chin have been well studied and documented by artists, scientists, and physicians Rhinoplasty and genioplasty are the surgical procedures for excellence to provide extreme and beautiful changes on the face
- the nose and the chin are human dominant features and can be artistically shaped and sculpted to bring the face into a more normal, aesthetically pleasing balance The analysis in conjunction of these structures is propose
- The purpose of this paper is to Determine the frequency of appearance of the Nasal- Chin Deformity and type of nasal and chin anomaly most commonly related to each other
- A multicenter retrospective study were conducted from 1994 to 2005
- Three hundred and forty four patients (293 females and 51 males) that had cosmetic surgery were review
- The mean age was 23.5 years
- The population studied consisted on Hybridize Race type Every patient was evaluated considering surgical risk factors and underwent a complete medical physical examination
- esthetic is a very complex issue and is beyond the scope of this paper talk about it , many studies have been published defining by mathematical analysis what constitutes an harmonic face, everybody is aware that there is a great variability and subjectivity in appreciation of facial beauty and even more difficult is to determine with precision topographic facial references points for those systems Facial analysis IN COSMETIC SURGERY is the combination of the eye of the surgeon with a little help of the points, lines and angles that comes from any facial analysis system The width of nose at its base should be approximately the distance between the eyes ( medial canthus ). Nasofacial angle = 36 degrees Nasofrontal angle = 120 degrees Nasomental angle = 130 degrees Mentocervical angle = 85 degrees
- The patients included in this study were those who had Genioplasty, rhinoplasty, and combination of both. Patients were classified into 3 categories based on the surgical procedure performed Group I: Isolated rhinoplasty Group II: Isolated genioplasty Group III: those patients that had in conjunction rhinoplasty and genioplasty Group I and II were performed under oral sedation and group III under general anaesthesia
- The surgical technique for all the categories included
- The basic close rhinoplasty technique include Tip-sculpting techniques Cephalic trim Alar suturing techniques Nasal tip grafting Nasal dorsal alignment Hump reduction Osteotomies Nasal base surgery
- For the chin we performed a Horizontal osteotomy of the mandibular symphysis …………it is a great versatile technique
- An Asymmetric patient with a nasal deviation and a mandibular asimetry with no maloclusion, she had 2 mm o midline dental deviation and no cross bite
- We did on her Rhinoseptoplasty and camouflage the mandibular deformity with only an horizontal osteotomy of the chin……………………………………………………………… as you can appreciate in the basal view
- Another nasal deviation……….this is an orthognathic case …………
- Vertical maxillary excess and chin deficiency, we impacted the maxilla 4 mm and advanced the chin 5 mmand a second surgical time I did the rhino septoplasty
- Another case With a possible diagnose of VME ….. a borderline patient, in this particular case I did not consider the lefort I because I rather to keep the tooth to lip relation in the range of 4 to 6 mm, given her the chance to look younger for longer time , long term results that’s what we look for ………. youthful appearance …….remember the downward migration of the lip over the years……. She only had a rhinoplasty and chin advancement
- On your right 7 years post op with an initial diagnose on yor left of a bimaxilar dentoalveolar biprotrutsion this is after the orthodontic treatment
- Once again………… surgical camouflage to hide the dominant negative trait with a nasal tip graft and a chin advancement
- Once again………… surgical camouflage to hide the dominant negative trait with a nasal tip graft and a chin advancement
- Once again………… surgical camouflage to hide the dominant negative trait with a nasal tip graft and a chin advancement
- Typical case
- Another typical case
- Another case with some other disharmonies
- Post op 4 years after the surgery
- 93 of a total of 344 patients had a nasal and chin deformity
- The surgical procedures for the nasal deformity highlight that …… 83 patients underwent a complete basic rhinoplasty
- Only in this group 79 of the 83 patients had a hump reduction …………. lateral nasal fractures were complementary in order to achieved a harmonic dorsum
- In 87 patients of the 93 , we advanced the chin with a range of 4 to 7 mm
- Of the 344 adults including in the study 85,6 % were females 92.9 % were caucasian, 88,5% were between 15 to 30 years 27,1% were diagnosed with Nasal Chin deformity, the deformities which were most frequently fund associated to each other were nasal hump ( 95,1 %) and anterior deficiency of the chin (93,6 %)
- Nasal and chin deformity had been studied separately. Facial harmony will not appear as “beautiful” unless the combination of different facial procedures on the hard tissues, soft tissues and complementary esthetical guidance The results of this study indicate that the Nasal- Chin Deformity have a statistically significant relation. Clinical consideration and surgical correction of this disharmony provide consistent, long-term esthetic improvement.