Facial Plast Surg 2021; 37(05): 646-650
DOI: 10.1055/s-0041-1725938
Original Research

Nasal Dorsum Reduction Simultaneous to Orthognathic Surgery: A Proof-of-Concept Report

Joan Birbe Foraster
1   Facial Plastic Surgery, Private Practice, Barcelona, Spain
2   Clinica B I R B E, Private Practice, Barcelona, Spain
› Author Affiliations

Abstract

This report describes a technique to reduce nasal dorsum excess simultaneously to orthognathic surgery (OS) through a Le Fort I osteotomy. It avoids the need to change from endonasal intubation to intraoral intubation. It also eliminates the need to open the dorsum, preserving the integrity of the triangular cartilages at the nasal dorsum keystone area, avoiding iatrogenic nasal dorsum deformities. A sample of five patients referred for OS who also sought improvement of their nasal aesthetics was selected to implement the technique. The aim of this proof-of-concept study was to evaluate the clinical outcome of simultaneous OS and nasal dorsum reduction. The following measurements were used to evaluate the procedure: patient satisfaction with a visual analog scale, photographic assessment, additional operative time, and complications related to the procedure. The average patient age was 23 years (range: 19–32 years). Three patients were women and two were men. In all patients, a high degree of patient satisfaction was observed with the aesthetic result of the nose and OS. No undesirable side effects or surgical complications occurred in any case. Total surgery time was increased by an average of 25 minutes. Nasal dorsum reduction through a Le Fort I approach during OS is a reliable and effective method to reduce nasal dorsum excess in patients seeking simultaneous OS and rhinoplasty.



Publication History

Article published online:
11 March 2021

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  • References

  • 1 Seah TE, Bellis H, Ilankovan V. Orthognathic patients with nasal deformities: case for simultaneous orthognathic surgery and rhinoplasty. Br J Oral Maxillofac Surg 2012; 50 (01) 55-59
  • 2 Waite PD, Matukas VJ, Sarver DM. Simultaneous rhinoplasty procedures in orthognathic surgery. Int J Oral Maxillofac Surg 1988; 17 (05) 298-302
  • 3 Sarver DM, Rousso DR. Plastic surgery combined with orthodontic and orthognathic procedures. Am J Orthod Dentofacial Orthop 2004; 126 (03) 305-307
  • 4 O'Ryan F, Lassetter J. Optimizing facial esthetics in the orthognathic surgery patient. J Oral Maxillofac Surg 2011; 69 (03) 702-715
  • 5 Saban Y, Daniel RK, Polselli R, Trapasso M, Palhazi P. Dorsal preservation: the push down technique reassessed. Aesthet Surg J 2018; 38 (02) 117-131
  • 6 Daniel RK. The preservation rhinoplasty: a new rhinoplasty revolution. Aesthet Surg J 2018; 38 (02) 228-229
  • 7 Mejia J World Medical Association Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. 2013 . Accessed June 20, 2016 at: http://www.wma.net/en/30publications/10policies/b3/
  • 8 Mohamed WV, Perenack JD. Aesthetic adjuncts with orthognathic surgery. Oral Maxillofac Surg Clin North Am 2014; 26 (04) 573-585
  • 9 Waite PD, Matukas VJ, Sarver DM. Simultaneous rhinoplasty procedures in orthognathic surgery. Int J Oral Maxillofac Surg 1988; 17 (05) 298-302
  • 10 Raffaini M, Cocconi R, Spinelli G, Agostini T. Simultaneous Rhinoseptoplasty and orthognathic surgery: outcome analysis of 250 consecutive patients using a modified Le Fort I osteotomy. Aesthetic Plast Surg 2018; 42 (04) 1090-1100
  • 11 Saban Y, Çakir B, Daniel R, Palhazi P. Preservation Rhinoplasty. 1st edition. Bio Ofset: Istanbul; 2018