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Aesthetic rhinoplasty: Changing trends
... In another schedule later, standard nose corrections are performed. [18][19][20] This includes the reduction of the height and width of columella, rounding of the tip of the nose, reducing the flare of the nares as well to accommodate any specific requirements of the patients [ Figure 3]. Root of nose corrections would have been accommodated at the first stage correction. ...
Introduction
Gender reassignment surgery for facial feminization is being increasingly sought out by males with gender nonconformity issues. Noninvasive camouflage measures such as changing hairstyle, makeup, and filler inserts often do not fetch desired long lasting effects and surgery is sought as a last resort. The facial feminization surgery (FFS) for Indian faces, has no definitive protocol till date and largely remains as an arbitrary undertaking based on individual patient's perception, expectation, and surgeon's ability. This manuscript aims to present a series of the Indian FFS and compare the same with European and African counterparts to highlight the Indian expectation of FFS and thus its modifications.
Materials and Methods
Seven patients confirming to gender nonconformity status, seeking FFS, aged between 21 and 36 years (mean 26.3 ± 4.2 years; median 25 years) were surgically treated during 2007–2014. Of them, five were of Indian origin and the rest two from the Europe and Africa. After investigation and para-clinical workup, FFS were carried out in stages with due modifications.
Results
Basic surgical guidelines were followed accommodating Indian parameters of facial profile as well as expectations. Various amounts of soft and hard tissue changes were required for individual patients, depending on their individual perception.
Conclusion
All seven patients were satisfied with their feminine faces. The challenges and differences in planning and performing Indian FFS are described.
... If properly planned and performed, nose feminization is never a challenge. [6] Similarly, pullback of the prominent ears can be performed. Correcting wide zygoma/arch to give the desired facial contour is also performed with ease. ...
... The relative facial beauty of a person depends on the size, shape & appearance of the nose to a great degree. 1 Over and above the functional & aesthetic aspects, the patient's reaction to his or her own nose as well as the reaction of the public to it contributes to the psychic aspects. ...
The increasing awareness about rhinoplasty as a cosmetic surgery and the rising
number of patients seeking this procedure was the motivation behind this study. Twenty patients in
whom augmentation rhinoplasty was done were monitored in terms of original deformity, the
various steps undertaken for correction, complications encountered and the results achieved.
Although the basic steps remain more or less the same, modifications were made according to
individual needs and surgical acumen. A proper preoperative counseling is mandatory to achieve a
satisfactory result.
Purpose
Craniofacial anatomy, as measured by facial anthropometric data, varies significantly between races. South Asia, comprised of eight countries, represents a large proportion of the global population and is the fastest-growing region of the world. This systematic review presents the facial anthropometric data collected for populations from this region.
Materials and Methods
This systematic review was conducted in accordance with PRISMA guidelines. A systematic review of the literature was conducted by an electronic search of the MEDLINE and Cochran databases, returning 1675 articles. Bibliographies of accepted articles were screened to identify further eligible studies.
Results
A total of 12 articles were considered eligible for the systematic review. Two studies were conducted in Bangladesh, 7 in India, and 3 in Nepal. No facial anthropometric data were found for populations from Afghanistan, Bhutan, Maldives, Pakistan, or Sri Lanka. Qualitative and quantitative parameters from the 12 studies were extracted.
Conclusion
There is a paucity of facial anthropometric data for South Asian populations. As South Asia has a significant prevalence of craniofacial anomalies and a burgeoning cosmetic facial surgery market, it is in the interest of both the craniofacial surgeon and the South Asian patient to collect baseline facial anthropometric data for this population.
The increasing awareness of rhinoplasty as a cosmetic surgery and the increasing number of patients seeking rhinoplastic surgery motivated us to do this study. 30 cases in whom rhinoplasty was done were monitored with regard to the various deformities present, the different aurgical steps undertaken for their correction, the complications encountered and the results achieved. Though the basic surgical steps remain more or less same, modifications according to individual need and surgical acumen, a proper preoperative counselling and a realistic level of expectation in both the surgeon and the patient can give a satisfactory result in a great majority of cases.
The goal of this article is to help U.S. plastic surgeons better understand why Indian American rhinoplasty is different from other ethnic rhinoplasties in their practice. The study is composed of three parts: a review of the cultural perspectives of Indian Americans toward aesthetic surgery, an investigation into the aesthetic ideals of the Indian American nose, and an overview of operative strategies to achieve these ideals.
A total of 35 Indian Americans who were dissatisfied with their nasal appearance were analyzed, 15 prospectively and 20 retrospectively. Group 1 consists of 15 Indian American women who were unhappy with the appearance of their nose. Standard photographs and anthropometric measurements were taken. Anterior and lateral photographic views were morphed to the patient's subjective ideal. Actual and ideal images were compared and analyzed. Group 2 consists of a retrospective review of 20 consecutive Indian American rhinoplasty cases with a follow-up of 1 to 6 years.
The majority of the group 1 participants complained of a dorsal "hump," a downwardly rotated tip, and/or a large nose. The average subjective ideal nasolabial angle was determined to be 101.6 degrees. Based on the authors' analysis, three categories of nasal deformities were identified and operative strategies are discussed. Evaluation of the 20 clinical cases indicated that a more conservative surgical approach is warranted in these patients.
Indian American rhinoplasty patients present a challenging range of nasal deformities requiring careful surgical planning. A clear understanding of the patient's desires is essential to achieving patient satisfaction.
Therapeutic, IV.
A large variety of graft materials have been used for augmentation rhinoplasty. To date there has been no graft material which can be regarded as completely satisfactory. The modern trend is to prefer autologous material to new biological material. The membranous bones of the calvarium are extremely suitable for augmenting moderate to severe saddle nose deformities. Calvarial bone grafts can be harvested easily, with minimum donor site morbidity and disfigurement. Our experience with calvarial bone grafts for augmentation rhinoplasty is presented.
For the last 4 years, the author has been using the open lower cartilaginous vault rhinoplasty, making an external cutaneous incision on the columella. After observing the improved results in patients with nasal tip, lateral crura, and medial crura difficulties, the author widely recommends the use of this procedure in selected patients. In addition to multiple advantages which have been reported useful in open-tip rhinoplasty in the past, the author has contributed two additional advantages: that it avoids scarring columella skin and that it can be extended to cope with defects of the entire lower cartilaginous vault. Disadvantages are some residual edema in some patients over a 6-months period and prolongation of operating time.
The thick oily and pigmented skin present in majority of tropical patients makes rhinoplasty challenging surgery. Rhinoplasty by the external approach though gaining increasing acceptance all over the world is yet to gain popularity in this country. Hypertrophied scars are not uncommon in coloured skin and the reluctance to give an external incision for a cosmetic procedure is natural. We started the external rhinoplasty approach with some reservations, however in a series of over seventy cases, no significant problem has been encountered, with the columellar scar. Accurate approximation of the columellar wound is probably a more important factor in wound healing than the skin colour. Our experience of external rhinoplasty is presented.
L~u'yngol. Otol. 105 q 1991 ) IO] 8-1020
- B Ba~r
- . R C Lul
- J Rhinoplasty
Ba~r. B. and Lul wmli. R.. C'M vari',d I'mne grafe~ for augmentation Rhinoplasty, J. L~u'yngol. Otol. 105 q 1991 ) IO] 8-1020. 3, Baser. B, Grewal D.S, Hiranmldani N.L. q 1989). Exlernal Rhin,plasty in tropic, J. LLryngOl. Oto1. (103 1198-120t.
Ptast Recons Surge. ripen Rhinoplasty withoul cakmlellar in scion
- Fabkfla H Holrnstrom
- Luzlt
Holrnstrom H, Fabkfla LuzLt1996) Ptast Recons Surge. ripen Rhinoplasty withoul cakmlellar in scion, 97:321 Indian Jaarnt2f &" Otofarv~zgr cmd Head and Neck Str VoL 55 No. I, J~mtiarv -Mm'ch 2003
Aesthetic &Functional Rhinoplasiy
- B Baser
Calvarial bone grafts for augnmentation Rhinoplasty
- B Baser
- R Luiwani
- B. Baser
External Rhinoplusty in tropic
- B Baser
- D S Grewal
- N L Hiranandani
Plast Recuns Surge, open Rhinoplasty withoul columellar in scion
- H Holmstrom
- Fabiola Luzi