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DOI: 10.1055/s-0044-1787678
Long-Term Results Using “Nair Hospital Precision Carving” Technique of Rhinoplasty
Abstract
Background and Objectives Convincing a patient who has undergone any aesthetic surgery to come for a long-term follow-up is extremely difficult. The result obtained after rhinoplasty usually stabilizes in the first year and it is unlikely to change after 2 years. The precision carving technique described in 2014 has been employed by us for the last several years. We wish to present long-term results (at least 2 years) obtained using this technique, now renamed as “Nair Hospital Precision Carving technique.” The unfavorable effects of warping are most apparent in the dorsum. So, we have chosen to assess results of dorsal onlay grafts only. This article presents the long-term results obtained using favorable warping technique.
Materials and Methods We have followed up 45 patients in whom dorsal augmentation was done using rib grafts for various indications like aesthetic, reconstructive rhinoplasty and cleft lip nasal deformity. Grafts were carved using the precision carving technique.
Results All patients were assessed at 6 weeks, 6 months, and at subsequent follow-up period of 2 to 10 years and photographs were taken at each visit. There was no major complication and all patients were satisfied with the appearance.
Conclusion The Nair Hospital Precision Carving technique utilizes unbalanced yet controlled and precise carving to achieve a variety of natural shapes for the objectives of contour fill and framework reconstruction in rhinoplasty, thus ensuring good long-term results.
Keywords
rhinoplasty - precision carving technique - dorsal onlay graft - nair hospital - aesthetic surgery - framework reconstruction - contour fillNote
The study was done in adherence to the Declaration of Helsinki protocol. Proper preprocedure consents were taken for surgery, documentation, and research purposes. Data storage was performed inconsistence with good clinical practice guidelines.
Authors' Contributions
U.B., A.P., A.H., A.S., and M.P. performed the surgeries. A.P., A.H., and A.S. wrote the manuscript. G.M., S.R., and P.M. collected the data.
Publication History
Article published online:
20 June 2024
© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Daniel RK. Radix and dorsum. In: Mastering Rhinoplasty. Berlin: Springer; 2010: 67-100
- 2 Daniel RK, Sajadian A. Secondary rhinoplasty: management of the overresected dorsum. Facial Plast Surg 2012; 28 (04) 417-426
- 3 Daniel RK. Rhinoplasty: dorsal grafts and the designer dorsum. Clin Plast Surg 2010; 37 (02) 293-300
- 4 Daniel RK. Rhinoplasty: septal saddle nose deformity and composite reconstruction. Plast Reconstr Surg 2007; 119 (03) 1029-1043
- 5 Daniel RK. Rhinoplasty and rib grafts: evolving a flexible operative technique. Plast Reconstr Surg 1994; 94 (05) 597-609 , discussion 610–611
- 6 Sherris DA, Kern EB. The versatile autogenous rib graft in septorhinoplasty. Am J Rhinol 1998; 12 (03) 221-227
- 7 Lovice DB, Mingrone MD, Toriumi DM. Grafts and implants in rhinoplasty and nasal reconstruction. Otolaryngol Clin North Am 1999; 32 (01) 113-141
- 8 Sheen JH. Tip graft: a 20-year retrospective. Plast Reconstr Surg 1993; 91 (01) 48-63
- 9 Endo T, Nakayama Y, Ito Y. Augmentation rhinoplasty: observations on 1200 cases. Plast Reconstr Surg 1991; 87 (01) 54-59
- 10 Bhat U, Garg S, D'Souza EJ, Agarkhedkar N, Singh IA, Baliarsing AS. Precision carving of costal cartilage graft for contour fill in aesthetic and reconstructive rhinoplasty. Indian J Plast Surg 2014; 47 (01) 25-35
- 11 Erol OO. Long-term results and refinement of the Turkish delight technique for primary and secondary rhinoplasty: 25 years of experience. Plast Reconstr Surg 2016; 137 (02) 423-437
- 12 Gurley JM, Pilgram T, Perlyn CA, Marsh JL. Long-term outcome of autogenous rib graft nasal reconstruction. Plast Reconstr Surg 2001; 108 (07) 1895-1905 , discussion 1906–1907
- 13 Yilmaz M, Vayvada H, Menderes A, Mola F, Atabey A. Dorsal nasal augmentation with rib cartilage graft: long-term results and patient satisfaction. J Craniofac Surg 2007; 18 (06) 1457-1462
- 14 Fry H, Robertson WV. Interlocked stresses in cartilage. Nature 1967; 215 (5096) 53-54
- 15 Fry H. Cartilage and cartilage grafts: the basic properties of the tissue and the components responsible for them. Plast Reconstr Surg 1967; 40 (05) 526-539
- 16 Harris S, Pan Y, Peterson R, Stal S, Spira M. Cartilage warping: an experimental model. Plast Reconstr Surg 1993; 92 (05) 912-915
- 17 Adams Jr WP, Rohrich RJ, Gunter JP, Clark CP, Robinson Jr JB. The rate of warping in irradiated and nonirradiated homograft rib cartilage: a controlled comparison and clinical implications. Plast Reconstr Surg 1999; 103 (01) 265-270
- 18 Gunter JP, Clark CP, Friedman RM. Internal stabilization of autogenous rib cartilage grafts in rhinoplasty: a barrier to cartilage warping. Plast Reconstr Surg 1997; 100 (01) 161-169
- 19 Erol OO. The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 2000; 105 (06) 2229-2241 , discussion 2242–2243
- 20 Daniel RK, Calvert JW. Diced cartilage grafts in rhinoplasty surgery. Plast Reconstr Surg 2004; 113 (07) 2156-2171
- 21 Kelly MH, Bulstrode NW, Waterhouse N. Versatility of diced cartilage-fascia grafts in dorsal nasal augmentation. Plast Reconstr Surg 2007; 120 (06) 1654-1659