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      Reducción de base nasal con disección subperióstica de tercio medio en rinoplastia primaria Translated title: Nasal base reduction with extended midface subperiosteal dissection in primary rhinoplasty

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          Abstract

          Resumen Introducción y objetivo. Las técnicas de reducción de base nasal son usadas frecuentemente en rinoplastias primarias y de revisión cuando la distancia interalar excede la distancia intercantal. La reducción de base nasal mas común es la resección directa de los alares. Los métodos alternativos incluyen aumentar la proyección del dorso nasal y las técnicas de medialización de bases alares. Investigamos en una población de nariz mestiza si la reducción de la base alar percutánea es una técnica útil para disminuir el ancho de la base alar y si el resultado perdura. Material y método. Estudio prospectivo sobre 20 pacientes evaluando la media de medidas de base nasal en el postoperatorio inmediato, a las 2 semanas, 6 meses, 1 año y 2 años, así como también investigando el nivel de satisfacción con este procedimiento. Resultados. De los 20 pacientes del estudio, el 80% (16 pacientes) fueron mujeres y 20% (4 pacientes) hombres. La media de medidas de base nasal en el postquirúrgico inmediato fueron: inmediato=32.15 mm (+/−2.25, SD); 2 semanas = 33.95 mm (+/−2.97, SD); 6 meses = 36.1' mm (+/−2.80, SD); 1 año = 36.42 mm (+/−2.86, SD); y 2 años = 36.42mm (+/−2.86, SD). Nuestro estudio muestra una reducción inmediata de base nasal de 10.8 mm, y una reducción final de 6.52 mm, correspondiendo a una perdida de reducción de 4.27 mm en el período de estudio. Las comparaciones realizadas entre los períodos de tiempo como a las 2 semanas y a los 6 meses y de 6 meses frente a 1 año muestran una diferencia significativa entre los grupos. Después de 1 año no hubo diferencia significativa hasta los 2 años, sugiriendo que el resultado final se obtiene aproximadamente al año de seguimiento. Conclusiones. De la experiencia de nuestro estudio podemos deducir que la reducción alar nasal percutánea es una herramienta útil para reducción de base nasal en pacientes con base alar ancha. Los resultados quirúrgicos se mantuvieron estables después de 1 año postoperatorio. Nivel de evidencia científica Terapéutico 4c

          Translated abstract

          Abstract Background and objective. Nasal base reduction techniques are frequently used in primary and revision rhinoplasties when interalar distance exceeds the intercanthal distance. The most common nasal base reduction technique is direct alar resection. Alternative methods include increasing dorsal nasal projection and nasal base medialization techniques. We investigate in a mixed-nosed population whether percutaneous alar base reduction is a useful technique to decrease the width of the alar base and whether the result lasts Methods. Prospective study including 20 patients measuring nasal base medial widths at immediate postoperative period, 2 weeks, 6 months, 1 year and 2 years; also investigate the level of patient satisfaction with this procedure. Results. Twenty patients in the study, 80% (16 patients) were women and 20% (4 patients) were men. Mean nasal base widths measured at the respective postoperative period were as follows: immediate = 32.15 mm (±2.25, SD); 2-weeks = 33.95 mm (±2.97, SD); 6 months = 36.10 mm (±2.80, SD); 1-year = 36.42 mm (±2.86, SD); and 2-year = 36.42 mm (±2.86, SD). Our study showed an immediate mean reduction of nasal base width of 10.8 mm, and a final mean reduction of 6.52 mm, corresponding to a 4.27 mm loss in reduction over the study period. comparisons made between subsequent consecutive time points, such as 2-week versus 6-months, and 6-months versus 1-year, continued to demonstrate a significant difference between groups. After 1 year, there was no statistical significance of the measurements relative to 2 years, suggesting that the final result was achieved after approximately 1-year of follow-up. Conclusions. Our study experience showed that percutaneous nasal reduction is a useful tool for nasal base reduction in patients with broad alar base. The surgical outcome remained stable after 1-year postoperatively. Level of evidence Therapeutic 4c

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          Most cited references26

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          A systematic review of interethnic variability in facial dimensions.

          The earliest recorded facial proportional analysis is in the Greek neoclassical canons (c. 450 b.c.). In contemporary times, there has not yet been a study that describes the relative differences in facial proportions among the world's different ethnic groups. The specific aim of this project was to perform a systematic review of data from the existing literature to evaluate the degree of variability in the facial dimensions among various ethnic groups.
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            Precision rhinoplasty. Part I: The role of life-size photographs and soft-tissue cephalometric analysis.

            B Guyuron (1988)
            I describe a simple technique of full-scale life-size photography using marker/stickers and a ruler at the side of the face as an index for magnification. I also report a technique of soft-tissue cephalometric analysis that consists of some new proportion and some old angles and measurements. This technique will enable the plastic surgeon, even if not artistically inclined, to draw an aesthetically pleasing and very proportionate profile outline of the nose and measure the proportions of the front view on the majority of patients. The difference between the patient's nasal outline and the planned nasal definition is then measured and expressed in quarters of millimeters to give the surgeon a very precise numeric guide for surgery. This will help the plastic surgeon define the aesthetic goals very accurately and also might be helpful in detecting other facial disharmonies that might be influential in the outcome of the rhinoplasty. Using this technique of analysis, along with the prediction guidelines extrapolated from my study on soft-tissue response to surgical alteration, one can develop a fairly predictable approach to rhinoplasty.
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              Analysis of the African American female nose.

              The African American nose has been broadly classified as ethnic yet it differs significantly in morphology from that of other ethnic groups with which it is categorized. The objectives of this study were to (1) establish an objective protocol for analysis of the African American female nose using anthropometric measurements, and (2) determine whether subjective subcategorization schemes are a reliable replacement for anthropometry. African American women (n = 107) between the ages of 18 and 30 years consented to participate in this study. Photographs and 14 standard anthropometric measurements were taken of the face and nasal region, including nose length, nose width, special upper face height, intercanthal distance, mouth width, nasal bridge inclination, nasal tip protrusion, ala thickness, nasal root width, nasal bridge length, tangential length of ala, length of columella, nasofrontal angle, and nasolabial angle. Nasal indices including nose width-nose height index, nasal tip protrusion-nose height index, and nasal tip protrusion-nasal width index were calculated. In addition, photographic analysis was performed to evaluate nostril shape, nasal base shape, and nasal dorsal height. Proportional relationships and subcategorization schemes were evaluated. A new method of nasal analysis for the African American woman uses the proportional relationships of the anthropometric measurements. Proportional relationships included a columellar to lobule ratio of 1.5:1, a nasolabial angle of 86 degrees, and an alar width to intercanthal distance ratio of 5:4. The nasal dorsal height classification scheme was the most reliable for subjective analysis. The degree of variability found within this group of young African American women is illustrated by the following indices and their respective ranges: nose width-nose height index mean, 79.7 (range, 57 to 102); nasal tip protrusion-nose height index mean, 33.8 (range, 23 to 46); and nasal tip protrusion-nose width index mean, 42.8 (range, 32 to 61). The guidelines provided are a baseline from which to begin analysis and evaluation.
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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                March 2023
                : 49
                : 1
                : 25-34
                Affiliations
                [1] Huixquilucan Estado de México orgnameHospital Ángeles de las Lomas México
                Article
                S0376-78922023000100005 S0376-7892(23)04900100005
                10.4321/s0376-78922023000100005
                b5434d1f-3400-44b8-b327-bb8ef1d438ed

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 01 October 2022
                : 03 February 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 10
                Product

                SciELO Spain

                Categories
                Estética

                Primary rhinoplasty,Rhinoplasty,Base nasal,Cirugía nasal,Rinoplastia primaria,Rinoplastia,Nasal base,Nasal surgery

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