COSMETIC SURGERY OF THE FACE
ALVIN I. GLASGOLD, M.D., HIGHLAND PARK T he increasing interest in facial cosmetic surgery is a trend that will continue. Keeping abreast of advances in this field can be difficult. This review will describe some of the newer and more important aspects of facial cosmetic surgery. RHINOPLASTY
The "open approach" to rhinoplasty has added an exciting new dimension to an old operation. The exposure, utilizing a transcolumella incision followed by elevation of the nasal skin, allows for greater accuracy in correcting certain nasal deformities. The external scar is not a problem and this procedure has been a great help in dealing with difficult problems. specifically for the correction of the traumatized, twisted nose and the poorly defined broad tip, and for revision nasal surgery.
The advantage of the open approach is the greater exposure, visualization, and more accurate diagnosis. The structural defect can be corrected by trimming, repositioning, and cartilage grafting. The broad, flat tip now can be projected by using large cartilage struts sutured in position (Figures IA and 1B).
Revision rhinoplasty always has been a dilemma for the nasal surgeon. A major disadvantage is under-taking a procedure in an already unhappy patient. As a result of scarring and other factors, achieving predictable improvement in revision surgery is difficult. Many capable surgeons have been reluctant to perform revision surgery which leaves an unhappy patient with no options. The open approach has allowed for more accurate correction of problems with a more predict-able result.
Dr. Glasgold is Associate Professor of Surgery. UMDNJ - Robert Wood Johnson Medical School. Piscataway. Correspondence may be addressed to Dr. Glasgold, 31 River Road, Highland Park. NJ 08904.
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