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Review Article Plastic and Aesthetic Research

Nasal dorsal aesthetic lines and rhinoplasty

technical tricks

Alexander Kutubidze

Department of Aesthetic Plastic Surgery, Esthetic Service Clinic, Tbilisi 0171, Georgia.
Address for correspondence: Dr. Alexander Kutubidze, Department of Aesthetic Plastic Surgery, Esthetic Service Clinic, Tbilisi 0171, Georgia.
E-mail: akutubidze@aol.com

ABSTRACT
Rhinoplasty surgery remains one of the most difficult operations of the face. Improving aesthetic
appearance and maintaining nasal function are inseparable goals in rhinoplasty surgery, and failure
to achieve either of these objectives can be devastating for the patient. After evaluating a variety of
rhinoplasty complications, increased attention was devoted to the surgical technique for reconstruction
of the dorsal aesthetic lines and nasal tip projection in the patient with a prominent dorsal hump. Based
on the modern concept of cartilage conservation, the autospreader flap rotation technique should be
considered when dorsal reduction is required. Autospreader flaps are a useful tool in the prevention of
postoperative nasal obstruction, segmental (inverted V) appearance, midfacial axial asymmetry and an
overdone supratip break. In addition, they assist in preserving ethnicity of the nose when desired. The
patient with a long nose, prominent dorsal hump, short nasal bones and low lower lateral cartilages
are considered to be an ideal candidate for an autospreader flap.
Key words:
Autospreader flap, nasal aesthetic anatomy, nasal dorsal aesthetic lines, open rhinoplasty, spreader graft

INTRODUCTION presenting for aesthetic rhinoplasty, with a high prevalence
of nasal deviation. The functions of the nose, specifically
[5]
The greatest challenge in primary aesthetic rhinoplasty respiration, humidification, filtration, temperature regulation
is the application of advanced anatomical, aesthetic and and protection, are regulated by the septum, turbinates and
ethnic principles to an individual case, thereby customizing nasal valves (internal and external). [5,6]
the procedure to achieve the most natural result for the Therefore, every rhinoplasty surgeon should cultivate a full
patient‑individualized treatment plan. [1,2] Specific factors understanding of intranasal and external nasal anatomy,
[7]
to be noted during the preoperative assessment for the the differential diagnosis for nasal obstruction, and the
optimization of aesthetic results include the patient’s elements of a complete nasal examination, including nasal
ethnicity, gender, nasofacial aesthetic and any specific endoscopy. In addition, a comprehensive analysis of the
requests. The endonasal (closed) and external (open) face and a broad understanding of the long‑term effects
techniques are the two main techniques used in both of healing forces on the ultimate nasal aesthetic and
primary and secondary rhinoplasty. [3,4] With both approaches, function are required. Knowledge of rhinoplasty medical
[5]
the goals are to preserve or achieve normal airflow while and surgical treatment options and side effects anatomical
delivering an aesthetically pleasing and natural permanent correlates can assist in anticipating them intraoperatively
long‑term result. Multiple studies have reported that nasal
obstruction is a relatively common problem in patients
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How to cite this article: Kutubidze A. Nasal dorsal aesthetic lines and
DOI: rhinoplasty technical tricks. Plast Aesthet Res 2015;2:315-9.
10.4103/2347-9264.169495
Received: 21-10-2014; Accepted: 22-10-2015

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