Technique for Correction of the Retracted Columella, Acute Columellar-Labial Angle, and Long Upper Lip

Flowers, Robert S.; Smith, Eugene M.

doi:10.1007/s002669900276

Cited by 9 publications

(9 citation statements)

References 7 publications

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“…Gunter described the most comprehensive and systematic classification of aesthetic alterations of alar-columellar relationships 5 . Although there are concerns about its complexity and application in clinical practice 6 , there is no doubt that accurate diagnosis facilitates selection of the best treatment option3 , [5][6][7][8][9][10][11][12][13][14] . Treatment options for aesthetic alterations of nasal columella vary according to the degree of deformity and surgeon preference and expertise.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have defined anatomical aspects of the perfect columella and its normal variations (2,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)16). Sheen reports that the perfect relationship between the columella and alar rims should not exceed 2-3 mm below a line parallel to their inferior border, on a profile view (4).…”

Section: Perfect Columella and Treatment Of Columella Disharmoniesmentioning

confidence: 99%

“…Similarly, there is abundant literature for the correction of nasal columella deformities in cleft lip and palate as well as "negroid nose" 2 . However, few authors have reported their experiences in aesthetic alterations of nasal columella [3][4][5][6][7][8][9][10][11][12][13][14] . The aim of this study is to describe our approach for aesthetic alterations of the nasal columella most commonly observed in our clinical practice; i.e.…”

Section: Introductionmentioning

confidence: 99%

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Aesthetic treatment of retracted and hanging nasal columellas

Ribeiro¹,

Pessôa²,

Andrade³

2014

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

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Rev. Bras. Cir. Plást. 2014;29(1):159 159 Special article Aesthetic treatment of retracted and hanging nasal columellas Tratamento estético da columela nasal: columela oculta e columela pendente LIACYR RIBEIRO¹ MARCELO CASTRO MARÇAL PESSOA² RENATO MONTEIRO DE ANDRADE³ 1-Former BSPS and ILAFPS President; Honorary Member of BSPS and ILAFPS; Member of ASAPS, ASPS, ISAPS; Member of the Academy. Fluminense of Medicine . 2-Member of BSPS, ISAPS -Plastic surgery. 3-Member of BSPS -Plastic surgery. Institution: Private hospital . ABSTRACTThis study discusses approaches for aesthetic correction of nasal columellas, i.e. retracted and hanging columellas, most commonly observed in clinical practice.We describe a chondral-mucoperichondrial nasal septal flap and direct or indirect approaches described by Randall as our preferred procedures to correct retracted and mild to moderate hanging columella, respectively. A combination of procedures is used in more severe cases, in addition to modified Armstrong and Joseph's approaches. These treatment options are compared to other literature reports on this specialty. RESUMOOs autores revelam, no presente trabalho, suas abordagens frente às alterações estéticas da Columela Nasal, mais observadas em sua prática clínica, a Columela Oculta e a Columela Pendente. Para a Columela Oculta os autores descrevem o uso de um Retalho Condro-mucopericondral do septo nasal como escolha preferencial. Para o tratamento da Columela Pendente os autores utilizam as abordagens, direta e indireta, descritas por Randall, nos casos leves a moderados, e para os casos mais acentuados utilizam uma associação de táticas além de uma modificação do que é descrito por Armstrong e Joseph. Suas opções de tratamento são confrontadas com o que há descrito na literatura da especialidade e seus resultados comparativos são apresentados.

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Section: Discussionmentioning

confidence: 99%

Section: Perfect Columella and Treatment Of Columella Disharmoniesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Aesthetic treatment of retracted and hanging nasal columellas

Ribeiro¹,

Pessôa²,

Andrade³

2014

Revista Brasileira De Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery

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“…Other authors have proposed various methods to correct similar categories that we have outlined. Flowers and Smith 13 have described a unique technique for correcting a retracted columella, an acute columellarlabial angle, and a long upper lip. A decorticated centrally based transverse flap from the lip and nostril is transposed into a columellar pocket that effectively shortens the upper lip, corrects the retracted columella, and opens the columella-labial angle.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of the Nasolabial Angle in Balanced Rhinoplasty

Pearlman

2006

Facial plast Surg

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Aesthetic rhinoplasty is a complex surgical procedure that contains numerous components; when performed harmoniously, it should yield a successful, balanced result. The process begins with a comprehensive nasal analysis and surgical planning. Many surgeons concentrate on altering the nasal dorsum and nasal tip but may ignore potential contributions to overall appearance from the caudal nasal septum and nasal spine. One of the key parameters for evaluation and aesthetic treatment of the nose is the nasolabial angle. The nasal spine, caudal septum, and the medial crura of the lower lateral cartilages provide the framework for this area. Alteration of these structures, as well as nasal tip rotation and projection, may affect the resultant nasolabial angle, length of the upper lip, and overall harmony of the nose. Fullness at the nasolabial junction by a pushing philtrum may also result in an unbalanced appearance. The literature is replete with methods for categorizing the nasal tip and recommended surgical treatments. Treatment of the caudal septum and the nasal spine is often an afterthought that is left to the aesthetic judgment of the surgeon. A chart-with recommended treatment for the caudal septum and nasal spine following appropriate profile analysis-is included in the interest of a more systematic process. The chart takes account of the length of the nose, nasolabial angle, and possible presence of a pushing philtrum with suggested treatments to allow for proper tip placement and aesthetic balance to the nose. Adherence to this process provides a valuable tool for assuring a harmonious result in rhinoplasty.

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“…These include a retracted columella, deficient caudal septum, acute columellar-labial angle, pollybeak deformity, septal perforation, hypoplastic premaxilla, and hypoplastic midface. 8,11 Techniques that complement dorsal augmentation should be employed to achieve an optimal cosmetic and functional result. Such corrective measures include septoplasty, septal reconstruction, septal extension grafts, columella strut grafts, soft tissue grafts, endonasal lining grafts, premaxillary bone grafts, and chin and malar implants.…”

Section: Nasal Analysismentioning

confidence: 99%

An Overview of Nasal Dorsal Augmentation

Dresner

Hilger

2008

Seminars in Plastic Surgery

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Structural deficiencies of the nasal dorsum most commonly derive from congenital, traumatic, and iatrogenic etiologies. Alternatively, dorsal deficiency may be a manifestation of a generally underprojected nose with otherwise appropriate relationships between the radix, dorsum, and tip. In analyzing dorsal deficiency, associated anatomic abnormalities leading to compromise of both aesthetic form and respiratory function must be recognized and incorporated into the reconstructive plan. The cornerstone of augmentation rhinoplasty employs either autologous graft or alloplastic implant material to restore dorsal height and structural support to the nasal skeleton. Many autologous and alloplastic materials are currently available to the rhinoplasty surgeon, each of which carries a characteristic profile of relative advantages and limitations. Although most rhinoplasty surgeons prefer autologous materials, the choice of material must be individualized to each patient. The reconstructive plan ultimately formulated emerges after thoughtful consideration of the extent of the dorsal deficiency, characteristics of the overlying skin-soft tissue envelope, history of prior surgery, associated structural abnormalities, preferences of the surgeon, and views of the patient. Regardless of the specific methods used to augment the nasal dorsum, optimizing the aesthetic profile and maximizing respiratory function in a sustainable manner with minimal patient risk and morbidity remain the primary objectives.

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Technique for Correction of the Retracted Columella, Acute Columellar-Labial Angle, and Long Upper Lip

Cited by 9 publications

References 7 publications

Aesthetic treatment of retracted and hanging nasal columellas

Aesthetic treatment of retracted and hanging nasal columellas

Surgical Treatment of the Nasolabial Angle in Balanced Rhinoplasty

An Overview of Nasal Dorsal Augmentation

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