Contemporary rhinoplasty methods: actualities and challenges

Abstract

Introduction. Rhinoplasty is a surgical procedure utilized to improve and reconstruct damaged or badly conformed nasal structures by grafting or by transplanting a portion of skin from another part of the body. Nasal surgical access can be obtained through two types of incisions: incisions made inside the nose (endonasal approaches) or through incisions made outside the nostrils (external approach). In recent years, two more types of non-surgical rhinoplasty have been introduced - rhinoplasty with dermal fillers and ultrasound. Aim of study. This review aims to investigate the existing rhinoplasty techniques, methods and indications. Methods and materials. A literature review of the scientific literature was made using PUBMED, Medline.plus , Medline.com,Google Scholar, PlasticSurgery.org, TripDatabase, Science Direct databases, for a period of 5 years. The review was supplemented with a manual search using the keywords: “nose rhinoplasty, grafts,methods” (PR) during the 2018 to 2023 time span. A study was carried out which included 5 patients ( 4 men and 1 woman, N=5), aged between 28-38 years old ( average age-33 years old) diagnosed with septum deviation (N=1), asymmetric nasal tip (N=1), asymmetric alar cartilage (N=1), nasal bone fractures (N=1). Contemporary rhinoplasty techniques such as endonasal, external and non-surgical with dermal fillers were applied to these patients. Results. Following the analysis of scientific articles and specialised works, contemporary rhinoplasty methods were analysed. According to a study carried out by Hyi Seong Kim, it was determined that the open rhinoplasty method is more precise, better outcomes were also obtained compared to closed rhinoplasty due to the transcolumellar incision which allows a more accurate evaluation of the anatomy of the nose. On the other hand, the author Cárdenas-Camarena L highlights that endonasal rhinoplasty could be a better method to prevent edema and bruising. Taking into account that a patient satisfaction survey was not performed, such as the NOSE and ROE scores, it is difficult to obtain scientifically accurate information about which technique is more likely to show better outcomes. Conclusion. Nasofacial aesthetic ideals are culturally variable, and they are influenced by the passage of time. Therefore, it is difficult to state the correct definition of what constitutes an aesthetically pleasing nose. The contemporary techniques used in this study proved to be effective through a minimally invasive approach, with no postoperative complications. It has been noted that the quality of life was significantly improved from a morpho-functional point of view. Besides nasal appearance, respiratory function can also be notably improved by these techniques. or badly conformed nasal structures by grafting or by transp lanting a portion of skin from another part of the body. Nasal surgical access can be o btained through two types of incisions: incisions made inside the nose (endonasal approaches) or th rough incisions made outside the nostrils (external approach). In recent years, two mor e types of non-surgical rhinoplasty have been introduced - rhinoplasty with dermal fillers and ultr asound. Aim of study. This review aims to investigate the existing rhinoplasty te chniques, methods and indications. Methods and materials. A literature review of the scientific literature was made using PUBMED, Medline.plus, Medline.com,Google Scholar, PlasticSurgery.o rg, TripDatabase, Science Direct databases, for a period of 5 years. The review was supplemen ted with a manual search using the keywords: “nose rhinoplasty, grafts,methods ” (PR) during the 2018 to 2023 time span. A study was carried out which included 5 patients ( 4 men and 1 woman, N=5), aged between 28-38 years old ( average age-33 years old) diagnosed with septum deviatio n (N=1), asymmetric nasal tip (N=1), asymmetric alar cartilage (N=1), nasal bone fractur es (N=1). Contemporary rhinoplasty techniques such as endonasal, external and non-surgical w ith dermal fillers were applied to these patients. Results. Following the analysis of scientific articles and spe cialised works, contemporary rhinoplasty methods were analysed. According to a study carri ed out by Hyi Seong Kim, it was determined that the open rhinoplasty method is more precise, better outcomes were also obtained compared to closed rhinoplasty due to the transcolumellar in cision which allows a more accurate evaluation of the anatomy of the nose. On the other ha nd, the author Cárdenas-Camarena L highlights that endonasal rhinoplasty could be a better met hod to prevent edema and bruising. Taking into account that a patient satisfaction survey was not performed, such as the NOSE and ROE scores, it is difficult to obtain scientifically a ccurate information about which technique is more likely to show better outcomes. Conclusion. Nasofacial aesthetic ideals are culturally variable, a nd they are influenced by the passage of time. Therefore, it is difficult to state th e correct definition of what constitutes an aesthetically pleasing nose. The contemporary techniques use d in this study proved to be effective through a minimally invasive approach, with no postoperative co mplications. It has been noted that the quality of life was significantly improved from a morpho-functional point of view. Besides nasal appearance, respiratory function can also be n otably improved by these techniques.