The Experts below are selected from a list of 17082 Experts worldwide ranked by ideXlab platform
Peter Hellings - One of the best experts on this subject based on the ideXlab platform.
-
preoperative symptoms of body dysmorphic disorder determine postoperative satisfaction and quality of life in aesthetic Rhinoplasty
Plastic and Reconstructive Surgery, 2013Co-Authors: Valerie A Picavet, Loes Gabriels, Jente Grietens, Mark Jorissen, Emmanuel P Prokopakis, Peter HellingsAbstract:BACKGROUND: In patients seeking aesthetic Rhinoplasty, a high prevalence of body dysmorphic disorder symptoms has recently been reported. However, the impact of these symptoms on the outcomes after Rhinoplasty remains elusive. This large-scale study determines the influence of preoperative body dysmorphic disorder symptoms on patients' postoperative satisfaction and quality of life, using validated questionnaires. METHODS: A 1-year prospective study of 166 adult patients undergoing cosmetic Rhinoplasty in a tertiary referral center was performed. Severity of body dysmorphic disorder symptoms was assessed by the modified Yale-Brown Obsessive Compulsive Scale. Postoperative satisfaction was evaluated using a visual analog scale for patients' appraisal of nasal shape and the Rhinoplasty Outcome Evaluation. Generic quality of life was quantified by the Sheehan Disability Scale, whereas the appearance-related disruption of everyday life was measured by the Derriford Appearance Scale-59. RESULTS: Preoperative body dysmorphic disorder symptom scores inversely correlated with postoperative satisfaction at 3 months (visual analog scale nasal shape: rho = -0.43, p < 0.001; Rhinoplasty Outcome Evaluation: rho = -0.48, p < 0.001) and 12 months (rho = -0.40, p < 0.001; and rho = -0.41, p < 0.001, respectively) after surgery. In addition, body dysmorphic disorder symptom scores positively correlated with Sheehan Disability Scale scores and Derriford Appearance Scale-59 scores at 3 months (rho = 0.43, p < 0.001 and rho = 0.48, p < 0.001, respectively) and 12 months (rho = 0.32, p < 0.001, and rho = 0.48, p < 0.001, respectively) postoperatively. CONCLUSION: This study provides the first evidence of the negative impact of preoperative body dysmorphic disorder symptoms on subjective outcomes after Rhinoplasty, hence unveiling a crucial factor in patient dissatisfaction after aesthetic Rhinoplasty.
-
long term patient satisfaction after revision Rhinoplasty
Laryngoscope, 2007Co-Authors: Peter Hellings, Gilbert Nolst J TreniteAbstract:Objective: In cases of dissatisfaction after Rhinoplasty for esthetic or functional reasons, or both, revision Rhinoplasty may be advocated to improve the patients' nasal performance. In contrast to studies on primary Rhinoplasty, no objective outcome evaluation parameter has been validated in revision Rhinoplasty, nor has there been a study specifically looking at long-term satisfaction after revision Rhinoplasty. We aim at studying patient satisfaction after a long-term follow-up of revision Rhinoplasty performed at an academic referral center. Methods: At a mean period of 2.5 years after revision Rhinoplasty, 90 patients who underwent a revision Rhinoplasty at the Academic Medical Center in Amsterdam, The Netherlands, were sent a questionnaire on general satisfaction together with the validated Rhinoplasty outcome evaluation (ROE) questionnaire. Results: Of the 46 patients who responded to the questionnaire, 88% experienced a significant improvement in nasal performance by revision Rhinoplasty, and 79% would choose to undergo the revision procedure again. Subgroup analysis of the ROE scores demonstrated that good satisfaction was mainly obtained in the young adult and middle-aged groups, without major differences between males and females. Satisfaction was unrelated to the open or closed technique used for revision, or to the graft material used. Interestingly, an inverse correlation was found between satisfaction and the number of previous rhinoplasties. Conclusions: This retrospective study demonstrates that revision Rhinoplasty in an academic practice provides most patients with long-standing satisfaction.
Anthony P. Sclafani - One of the best experts on this subject based on the ideXlab platform.
-
Revision Rhinoplasty.
Facial plastic surgery : FPS, 2020Co-Authors: Thomas Romo, Jonathan Sonne, Kyle S Choe, Anthony P. SclafaniAbstract:Revision Rhinoplasty can be one of the most complicated procedures performed by the facial plastic surgeon. As septal cartilage is often not available in revision procedures, grafting material is often needed. This material can come in the form of autogenous bone and cartilage. Allografts also can be used, including mersilene, expanded polytetrafluoroethylene, and porous high-density polyethylene (PHDPE). In this article, emphasis is placed on the senior author's method in evaluating candidates for revision Rhinoplasty as well as techniques using PHDPE. In addition, the properties of the more commonly used allografts are described, including the advantages and disadvantages of using each material in revision Rhinoplasty procedures. In comparing the various alloplastic materials available, it is shown that PHDPE has properties that make it an excellent implant for revision Rhinoplasty.
-
postoperative pain and analgesic requirements after septoplasty and Rhinoplasty
Laryngoscope, 2019Co-Authors: Anthony P. Sclafani, Klaus Kjaer, Ashutosh Kacker, Abtin TabaeeAbstract:OBJECTIVES/HYPOTHESIS: To assess and define the level of pain after Rhinoplasty and septoplasty and to better define the strength and quantity of postoperative opioids needed. STUDY DESIGN: Prospective outcomes research. METHODS: Two groups of patients were enrolled. One group underwent septoplasty with/without turbinate reduction and the other group underwent functional and/or cosmetic Rhinoplasty (with/without septoplasty). Patients completed a 15-day log (daily, beginning on the day of surgery) to record the analgesics used and the daily maximal level of pain using a visual analog scale. Level of pain, number of days of moderate or severe pain, total number of opioid pills used, and total morphine milligram equivalents (MMEs) of opioid used were assessed. RESULTS: Pain after septoplasty and Rhinoplasty was generally mild. Average pain was moderate through postoperative day (POD) 2 after Rhinoplasty and only on POD 0 after septoplasty. There was no statistically significant difference between the two groups in terms of number of opioid tablets consumed or total MMEs used. Patients undergoing Rhinoplasty consumed more acetaminophen than septoplasty-only patients (7471 ± 1009 vs. 2781 ± 585, P = .0112). Ninety percent of patients would have received adequate analgesia with as few as 11 opioid tablets. All patients had excess opioid at the end of the study period. CONCLUSIONS: Both septoplasty and Rhinoplasty are associated with mostly mild pain, and postoperative opioid requirements are quite low. Surgeons can reliably reduce opioid prescription after septoplasty and Rhinoplasty to as few as 11 tablets. Reducing opioid prescribing will not adversely affect the patient but will reduce the availability of opioids for misuse or diversion. LEVEL OF EVIDENCE: 2c Laryngoscope, 129:2020-2025, 2019.
-
Revision Rhinoplasty Using Porous High-Density Polyethylene Implants to Reestablish Ethnic Identity
Aesthetic Plastic Surgery, 2006Co-Authors: Thomas Romo, Edward S. Kwak, Anthony P. SclafaniAbstract:Background This study aimed to evaluate a surgical technique used for patients requiring revision Rhinoplasty to reestablish their ethnic identity. Methods A retrospective review involved 29 patients who underwent revision Rhinoplasty to reestablish their ethnic identity using residual septal cartilage and porous polyethylene implants. The follow-up period ranged from 6 month to 7 years. Results For all patients undergoing revision Rhinoplasty, multiple porous polyethylene implants were used to reestablish ethnic identity and to restore nasal function. Implant extrusion developed in one (3.4%) of the 29 patients. There were no cases of postimplant infection. Conclusions In our experience, patients who feel they have lost their ethnic identity after primary Rhinoplasty tend to have overresected dorsal cartilage and bone and overresected tip cartilages. The use of multiple porous polyethylene implants in revision Rhinoplasty to restore ethnic identity can provide the necessary grafting material needed for reconstruction. Many grafting options are available. According to our experience, porous polyethylene provides safe, effective, and reliable results.
Gilbert Nolst J Trenite - One of the best experts on this subject based on the ideXlab platform.
-
long term patient satisfaction after revision Rhinoplasty
Laryngoscope, 2007Co-Authors: Peter Hellings, Gilbert Nolst J TreniteAbstract:Objective: In cases of dissatisfaction after Rhinoplasty for esthetic or functional reasons, or both, revision Rhinoplasty may be advocated to improve the patients' nasal performance. In contrast to studies on primary Rhinoplasty, no objective outcome evaluation parameter has been validated in revision Rhinoplasty, nor has there been a study specifically looking at long-term satisfaction after revision Rhinoplasty. We aim at studying patient satisfaction after a long-term follow-up of revision Rhinoplasty performed at an academic referral center. Methods: At a mean period of 2.5 years after revision Rhinoplasty, 90 patients who underwent a revision Rhinoplasty at the Academic Medical Center in Amsterdam, The Netherlands, were sent a questionnaire on general satisfaction together with the validated Rhinoplasty outcome evaluation (ROE) questionnaire. Results: Of the 46 patients who responded to the questionnaire, 88% experienced a significant improvement in nasal performance by revision Rhinoplasty, and 79% would choose to undergo the revision procedure again. Subgroup analysis of the ROE scores demonstrated that good satisfaction was mainly obtained in the young adult and middle-aged groups, without major differences between males and females. Satisfaction was unrelated to the open or closed technique used for revision, or to the graft material used. Interestingly, an inverse correlation was found between satisfaction and the number of previous rhinoplasties. Conclusions: This retrospective study demonstrates that revision Rhinoplasty in an academic practice provides most patients with long-standing satisfaction.
Rod J. Rohrich - One of the best experts on this subject based on the ideXlab platform.
-
Ethnic Rhinoplasty.
Clinics in plastic surgery, 2020Co-Authors: Rod J. Rohrich, Kelly BoldenAbstract:As the United States becomes more racially and ethnically diverse, the number of non-Caucasian patients seeking Rhinoplasty is increasing. The non-Caucasian, or ethnic, Rhinoplasty patient can be a surgical challenge due to the significant anatomic variability from the standard European nose as well as variability within each ethnicity. Becoming familiar with the common anatomic differences as well as the aesthetic goals in the ethnic Rhinoplasty patient will assist the surgeon in attaining consistent, ethnically congruent, and aesthetically pleasing results.
-
evidence based nasal analysis for Rhinoplasty the 10 7 5 method
Plastic and reconstructive surgery. Global open, 2020Co-Authors: Iris M Brito, Yash J Avashia, Rod J. RohrichAbstract:: Rhinoplasty is one of the top 5 aesthetic surgical procedures performed in plastic surgery. A methodical evaluation based on solid and up-to-date scientific evidence in different key areas of nasal and facial analysis is presented, the 10-7-5 method. This represents the most important preoperative step for a successful Rhinoplasty. The 10-7-5 method for nasal analysis is a useful instrument that provides the Rhinoplasty surgeon a deep comprehension of nasal anatomy. Understanding the nasal structures' main relationships and consequences of each surgical maneuver on nasal framework assists on establishing the appropriate surgical goals for each patient, both in primary and secondary Rhinoplasty cases. This systematic analysis of patient's frontal, lateral, and basal nasal views provides a background to identify changes to ideal aesthetic proportions and how to surgically restore them while maintaining gender and ethnic congruency.
-
Male Rhinoplasty: Update.
Plastic and Reconstructive Surgery, 2020Co-Authors: Rod J. Rohrich, Raja MohanAbstract:: Male Rhinoplasty is unique in that it requires precise preoperative planning to achieve a successful result. Better communication and clarity are paramount with male Rhinoplasty patients because the patients may be less attentive. It is important for the surgeon to screen the patients for any psychosocial disorders. Through a series of cases, male Rhinoplasty techniques are highlighted. Masculine features should be preserved, and the nose should not be feminized or oversculpted. Another key component in any Rhinoplasty case is proper skin care, especially during the postoperative period. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, V.
-
Primary Open Rhinoplasty.
Plastic and Reconstructive Surgery, 2019Co-Authors: Rod J. Rohrich, Paul N. AfroozAbstract:LEARNING OBJECTIVES: After studying this article and viewing the videos, the participant should be able to: 1. Describe the operative technique necessary to perform open Rhinoplasty. 2. Summarize the steps necessary in performing a component dorsal reduction. 3. Develop a surgical plan for nasal tip shaping and cephalic rotation of the nasal tip. 4. Identify the need for aesthetic improvement of the alar base, and perform successful alar base surgery. 5. Demonstrate consistency, safety, and predictability in Rhinoplasty. SUMMARY: Rhinoplasty remains one of the most challenging procedures in plastic surgery, and continues to be one of the top five aesthetic surgical procedures, with over 223,000 performed in 2016. Rhinoplasty may be performed by means of the "open" or the "closed" approach, and each approach has its advantages and disadvantages. This article focuses on the open approach, and the principles and techniques necessary to achieve consistent and gratifying results. As with all plastic surgery procedures, successful Rhinoplasty begins with a thorough clinical analysis, definition of the goals, meticulous preoperative planning, precise operative execution, vigilant postoperative management, and a critical analysis of one's results.
-
Middle Eastern Rhinoplasty: Update.
Plastic and reconstructive surgery. Global open, 2018Co-Authors: Rod J. Rohrich, Raja MohanAbstract:Middle Eastern Rhinoplasty is a topic of special importance within the broader category of ethnic Rhinoplasty. Among all aesthetic surgeries, Rhinoplasty is the one most commonly performed in this population. Tehran in Iran has been termed the “Rhinoplasty capital of the world” and the rate of Rhinoplasty is 7 times more than that of United States.1 The term Middle Eastern is quite broad and includes individuals: (1) Gulf countries (Iran, Saudi Arabia, Kuwait, Qatar, Oman, Bahrain, United Arab Emirates, Yemen); (2) North Africa (Egypt, Libya, Algeria, Morocco); (3) various other countries (Lebanon, Afghanistan, Syria, Turkey, Greece, Armenia).2–4 Although these regions encompass most Middle Eastern patients, there are salient differences between patients. In one review, patients from non-Gulf countries preferred more tip projection and less of a dorsal hump compared with other regions.5 In ethnic Rhinoplasty, the key is to avoid changing one’s ethnic identity or appearance by making radical changes.4 Attempting to perform a Rhinoplasty meant for a lower Fitzpatrick grade on patients with broader features and thicker skin may create an oversculpted appearance. Middle Eastern patients typically have reasonable requests with very high expectations.6 Despite their expectations, an outcomes study reported higher quality of life in Middle Eastern patients who underwent Rhinoplasty.7,8 This surgery can be very rewarding for these patients.
G Eskiizmir - One of the best experts on this subject based on the ideXlab platform.
-
deviated nose attenuates the degree of patient satisfaction and quality of life in Rhinoplasty a prospective controlled study
Clinical Otolaryngology, 2013Co-Authors: C Cingi, G EskiizmirAbstract:Objective To analyse and compare the patient satisfaction and quality of life in patients with and without deviated nose deformity who underwent Rhinoplasty. Design Prospective, before–after trial. Setting Tertiary referral centre. Participants A total of 191 patients who underwent primary Rhinoplasty between 2006 and 2009 were included. The study population was separated into two groups: non-deviated (patients with an external nasal deformity of less than 50) and deviated nose (patients with an external nasal deformity of more than 50). Main Outcome Measures The angles of deviations were measured from the pre- and postoperative photographs by an image analysis software program. Patient satisfaction and quality of life were measured by Rhinoplasty outcome evaluation and European Quality of Life-5 Dimension questionnaires before and after surgery. Results Eighty-one cases had deviated nose deformity; on the other hand, 110 cases had nasal deformities other than deviated nose deformity. The objective analysis of surgical outcome demonstrated a statistically significant improvement in the favour of postoperative results in both non-deviated (P = 0.0004) and deviated (P = 0.0002) nose groups. In addition, Rhinoplasty outcome evaluation and European Quality of Life-5 Dimension questionnaires demonstrated remarkable improvement in both non-deviated and deviated nose groups after Rhinoplasty. However, the comparison of pre- and postoperative change between non-deviated and deviated nose groups demonstrated statistically significant differences in almost all questions (except family and friends' satisfaction with appearance P = 0.069) and total score (P < 0.001) of Rhinoplasty outcome evaluation questionnaire, European Quality of Life-5 Dimension index (P < 0.001), European Quality of Life-5 Dimension visual analogue scale (P = 0.036) and living quality index (P < 0.001) with lower scores in deviated nose group. Conclusion Rhinoplasty can provide an objective improvement, high satisfaction and positive impact on quality of life. However, the degree of satisfaction and improvement in quality of life in patients with deviated nose deformity are less than patients with non-deviated nose deformity.
