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Rinoplastia - Deformidad nasal - Nasal Chin deformity
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Rinoplastia - Deformidad nasal - Nasal Chin deformity

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Deformidad Nasal. Operaciones de rinoplastia y cirugía estética facial para conservar la armonía facial. Casos de estudio del Dr. Samuel Benarroch. ...

Deformidad Nasal. Operaciones de rinoplastia y cirugía estética facial para conservar la armonía facial. Casos de estudio del Dr. Samuel Benarroch.

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  • 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.

Rinoplastia - Deformidad nasal - Nasal Chin deformity Rinoplastia - Deformidad nasal - Nasal Chin deformity Presentation Transcript

  • RHINOPLASTY Minimizin complications
    • Samuel Benarroch Mahfoda MD, DDS
    • Oral & Maxillofacial Surgery
    www.clinicabenarroch.com 902 11 06 47
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  • 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
  • DESIGN
    • Multicenter
    • Retrospective study
    • Conducted from 1994 to 2005
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  • PATIENT DISTRIBUTION SEX www.clinicabenarroch.com 902 11 06 47 SEX NUMBER % MALE 51 14.70 FEMALE 293 85.30 TOTAL 344 100
  • 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
  • POPULATION
    • HYBRIDIZED RACES
    www.clinicabenarroch.com 902 11 06 47 RACES NUMBER % CAUCASOID 319 92.94 NEGROID 19 5.52 MONGOLID 2 0.70 OTHER TOTAL 4 344 0.83 100
  • Facial Harmony www.clinicabenarroch.com
  • 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
  • SURGICAL TECHNIQUES
    • BASIC CLOSED RHINOPLASTY
    • HORIZONTAL OSTEOTOMY
    • OF THE CHIN
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  • BASIC CLOSED RHINOPLASTY www.clinicabenarroch.com 902 11 06 47
  • CASES www.clinicabenarroch.com 902 11 06 47
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    • KA, F, 23 yr. Sep, 2003
    • PROBLEM LIST
      • Nasal deformity
      • Full inframalar contour
      • Drooping lower lip
      • Chin deficiency
      • Neck lipomatosis
    • SURGICAL PLAN
      • Nasal and chin surgery
      • Lip plasty
      • Buccal fatpad removal
      • Neck liposuction
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  • 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
  • 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
  • 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
  • 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
  • RESULTS
    • 85.6 % FEMALES
    • 92.9 % CAUCASIAN
    • 88.5% 15 TO 30 YEARS
    • 27.1% NASAL CHIN DEFORMITY
    • DEFORMITIES MOST FREQUENTLY ASSOCIATED
      • NASAL HUMP 95.1 %
      • ANTERIOR DEFICIENCY OF THE CHIN 93.6 %
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  • CONCLUSIONS
    • Nasal and chin deformity had been studied separately.
    • Facial harmony will not appear as “beautiful” unless the combination of different facial procedures performing on the hard tissues and soft tissues
    • Esthetical guidance for the new face is necessary
    • The Nasal- Chin Deformity have a statistically significant relation.
    • Clinical consideration and surgical correction of this disharmony provide consistent, long-term esthetic improvement
    www.clinicabenarroch.com 902 11 06 47
  • THANK YOU FOR YOUR KIND ATENTION Samuel Benarroch Mahfoda MD, DDS Oral & Maxillofacial Surgery NASAL CHIN DEFORMITY www.clinicabenarroch.com 902 11 06 47