Plastic forming the tip of the nose
Plastic Surgery.The plastic forming the tip of the nose.After forming the back of the nose and behind the other phases of intervention with the use of tougher instruments usually proceed to the most precise part of the operation - the formation of the tip of the nose.However, in the hands of a skilled surgeon, holding methods open rhinoplasty, reduction of the upper third of the nose can be performed to correct the nose tip, and after it, depending on what the projection tip.So, at a sufficient height of the nose tip of the removal of osteochondral hump should be done first.If the projection of the tip of the nose is small, it is first necessary to ensure the maximum height of the tip of the nose, and then to make the removal of osteochondral hump so as not to cause deformation of the saddle then the effect of the nasal bridge.
Plastic forming the tip of the nose.The final
1. The change in shape while maintaining structural continuity of the nose cartilage elements.
2. Using a suture technology, which are adjustable and fully reversible (can dissolve the seams);
3. Achieving sufficient projection of the nasal tip and positioning elements without the use of "visible" transplants ( "vnakladku").
All these principles are based on the concept that the cartilaginous framework of the nose tip, formed the lower lateral cartilages, it looks like a tripod.In the upright position of the patient lower support "tripod" is represented medial legs and two upper bearing consists of a lateral legs.It is known that the manipulation of the length of the medial and lateral legs, and with additional cartilage and ligaments, and fixing the reinforcing cartilage, change the position of the tip of the nose.For the shortening of the medial leg or weakening their support down the tip of the nose and shifts it ventrally.The shortening of the lateral leg rotates nose upwards and backwards.The shortening of the three legs "tripod" reduces protrusion (projection) moves the tip of the nose and its ventral.Extension of the lower legs "tripod" (medial legs) raises the tip of the nose in the cephalic direction and pushes it forward.An additional shortening of the lateral legs in this situation increases the effect of rotation of the tip of the nose in the cephalic direction.
cartilaginous frame tip of the nose looks like a tripod (for Anderson)
Bundles, strengthen cartilage nose
shortening the medial legs or weakening their support lowered nose (rotation caudal and ventral)
Shortening twothe upper legs of the tripod (lateral legs) rotates nose up
shortening of all three pillars of the tripod (lateral and medial legs) reduces the projection (height) the nasal tip
Extension tripod lower leg raises tip in cephalic direction and pushes it forward
lengthening and shortening of the medial lateral legs enhance the effect of rotation of the tip of the nose in the cephalic direction
application of the principles of "tripod" allows you to correct the deformation of the tip of the nose in the form of his departure in the direction of a violation of the axial symmetry.The basis for such correction is septoplasty with subsequent shortening of the lateral and medial legs hyperplastic lower lateral cartilage on one side.
Unilateral resection of the medial and lateral leg to eliminate the asymmetry of the nasal tip