Rhinoplasty is a field with monikers that seem to describe and offend at the same time, such as pollybeak deformity and inverted V deformity. A new name is added to the list dubbed the "long nostril patient". This term was described by Dr. Anil Shah and coauthors in regards to a specific situation seen in rhinoplasty in a recent scientific paper was published in JAMA Facial Plastic surgery. This description compares the length of nostril in relationship to the overall projection of the nose. Patients with "long nostrils" were found to have longer than ideal lower lateral cartilages (tip cartilage). Dr. Shah and coauthors found that reduction in true length of nostril could be achieved by actually reducing the true length of the lower lateral cartilage.
Recently, Dr. Shah and coauthors published a scientific paper on alar retraction which was published in JAMA Facial Plastic Surgery September/October 2013.
(http://www.shahfacialplastics.com/articles/alar-retraction-etiology-treatment-and-prevention.html) Alar retraction is when one of the nostrils is retracted further up than the other. Prior to this paper being published, most surgeons assumed that alar retraction was something seen only in revision or redo rhinoplasty procedures. However, this paper demonstrated that alar retraction can be seen in patients without a history of previous rhinoplasty surgery. This paper also discusses how the use of cartilage grafts improved outcomes of patients versus those who did not have cartilage placed. Alar retraction is one of the most difficult rhinoplasty problems to correct, but this paper will help to broaden the understanding of alar retraction and possible solutions to correct it.
1. Facelift is actually describes both a face and neck lift. A facelift is designed to improve the neck, jawline, and the face. However, a faceneckjawlift is too cumbersome to say so facelift is the accepted terminology.
2. The average plastic surgeon performs only 12 facelifts per year. That means a surgeon with 20 years of experience may have only performed 200 or fewer facelifts. It is said that a facelift surgeon needs to have performed a minimum of 300 facelifts before they are considered competent. Make sure you go to a surgeon with enough experience. For example, Dr. Shah has performed over 1000 facelifts.
3. A facelift can be performed while you are awake. Patients now have a choice for which type of anesthesia for a facelift, which includes general, iv sedation, and local anesthesia.
4. The first facelift was said to be performed in Berlin Germany by Eugene Hollander in 1901. He lifted a portion of skin, removed it and sutured the skin. Unfortunately, this skin only approach, while technically easier to perform has been shown to not be effective and is still used by many surgeons today.
5. The neck muscle called the platysma actually goes into more than half of the face. This relationship was first described by Dr. Anil Shah and Rosenberg in 2007. This muscle is actually one of the more important aspects which should be addressed in a facelift, yet is done by only a select few.
1. The first rhinoplasty was performed in India by the ayuverdic physician Sushurta in 800 B.C. He developed plastic surgery techniques for reconstructing noses after they were amputated for criminal punishment. These techniques were discovered centuries later by British physicians in the 18th century.
2. The average plastic surgeon performs only 7 rhinoplasties per year. Only 5% perform more than 100 rhinoplasties per year. Make sure you go to a surgeon who performs at least one hundred rhinoplasties per year. For example, Dr. Shah performed over 300 rhinoplasty procedures in 2013.
3. It can take more than one year for a nose to heal after a rhinoplasty. This is in part due to swelling and lymphatic drainage of the nose. There are procedures to expedite this process such as taping and injections to the nasal tip.
4. Rhinoplasty can be used to help the nose breathe better. The inside of the nose is made up of cartilage and boney structure called the nasal septum. When it is deviated it can lead to nasal obstruction.
5. Rhinoplasty is thought to be the most challenging of plastic surgery procedures. The revision rate of rhinoplasty is reported to be as high as 20-30%. Find an experienced rhinoplasty surgeon with a low rate of revision to help improve your outcome.