Deformidad Nasal. Operaciones de rinoplastia y cirugía estética facial para conservar la armonía facial. Casos de estudio del Dr. Samuel Benarroch.
Más información en: http://www.clinicabenarroch.com/blog/rinoplastia-o-rinomodelacion.html
3. 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 902 11 06 47
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5. PATIENT DISTRIBUTION SEX www.clinicabenarroch.com 902 11 06 47 SEX NUMBER % MALE 51 14.70 FEMALE 293 85.30 TOTAL 344 100
6. PATIENT DISTRIBUTION AGE www.clinicabenarroch.com 902 11 06 47 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
9. PATIENT DISTRIBUTION SURGICAL PROCEDURE GROUPS www.clinicabenarroch.com 902 11 06 47 GROUPS PROCEDURE NUMBER % I RHINOPLASTY 138 40.01 II GENIOPLASTY 113 32.94 III RHINOGENIOPLASTY 93 27.05 TOTAL 344 100
26. DISCUSION GROUP III www.clinicabenarroch.com 902 11 06 47 GROUPS PROCEDURE NUMBER % I RHINOPLASTY 138 40.01 II GENIOPLASTY 113 32.94 III RHINOGENIOPLASTY 93 27.05 TOTAL 344 100
27. SURGICAL PROCEDURES RHINOPLASTY GROUP III www.clinicabenarroch.com 902 11 06 47 PROCEDURE NUMBER % BASIC RHINOPLASTY 83 89.6 NASAL WITDH AISOLATED 7 7.3 NASAL TIP AISOLATED 3 3.1 TOTAL 93 100
28. GROUP III BASIC RHINOPLASTY N 83 www.clinicabenarroch.com 902 11 06 47 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
29. HORIZONTAL OSTEOTOMY OF THE CHIN GROUP III www.clinicabenarroch.com 902 11 06 47 DISPLACEMENT NUMBER % ANTERIOR 87 93.6 TRANSVERSAL 4 4.4 VERTICAL 1 1.1 POSTERIOR 1 0.9 TOTAL 93 100
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32. THANK YOU FOR YOUR KIND ATENTION Samuel Benarroch Mahfoda MD, DDS Oral & Maxillofacial Surgery NASAL CHIN DEFORMITY www.clinicabenarroch.com 902 11 06 47
Notas del editor
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
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
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.