4973 Aesthetic Rhinoplasty: Experience of 1283 Cases In 23 Years

Friday, May 6, 2011
Daniel Volpato1, Gustavo Adolfo Almanzar German2, Rodrigo d'Eça Neves, MD3, Jorge Bins Ely, MD, MSc, PhD3, Leonello Ellera Bochese, MD3, Juan Camilo Aleán, MD3, Geovani Baptista dos Santos, MD3, Dimitri Cardoso Dimatos, MD3, Arthur Koerich d'Avila, MD3, Felipe Wohlgemuth, MD4 and Fabrício Ferreira, MD3, (1)Serviço de Cirurgia Plástica, Universidade Federal de Santa Catarina - Brazil, Florianópolis, Brazil, (2)Serviço de Cirurgia Plástica, Universidade Federal de Santa Catarina, Florianópolis, Brazil, (3)Serviço de Cirurgia Plástica (Division of Plastic Surgery), Hospital Universitário - Universidade Federal de Santa Catarina, Florianópolis, Brazil, (4)Serviço de Cirurgia Plástica (Division of Plastic Surgery), Hospital Universitário - Universidade Federal de Santa Catarina, Florianopolis, Brazil
Goals/Purpose: The objective of this presentation is to demonstrate the experience of twenty-seven years of aesthetic rhinoplasty in Clinica Jane – Brazil, with pictures and data of a long-term outcome, discuss about the techniques after a fine review about the advanced anatomy, physiology and the new concepts in rhinoplasty.

Methods/Technique: For many plastic surgeons rhinoplasty is the most challenging and difficult procedure in our area and has been a source of abiding interest for us throughout our careers, due both to the diversity of the techniques and to the difficulty in foreseeing long-term outcomes. Each patient has a different nasal anatomy, dictated by genetic inheritance - race, thus requiring a different technique for each case. The international literature emphasizes the techniques used for the Caucasian nose, which is not the only kind seen in our region. Some patients undergo rhinoplasty for cosmetic reasons, many for correction of functional problems with the nose, such as congestion or obstruction. Is crucial to the rhinoplasty surgeon today a thorough understanding of nasal function and the impact of rhinologic disease processes. Nasal septal deformity is one of the most important causes of respiratory obstruction in children, responsible for chronic rinossinusites, otites media, feeding difficulty and complications of oral breathers. Surgical correction should be performed, early in life, when indicated.

Results/Complications: This is twelve-hundred and eighty three cases of aesthetic rhinoplasty in the period of 1982 to 2009. Females prevailed 997 (78%). The surgery was combined in 325 cases (25%) and the most frequent intervention was the facial lift. Secondary rhinoplasty was performed in 93 cases (7%).

Conclusion: Modern rhinosurgery pursues the goal of long term results, which are functionally and aesthetically durable over decades. Today there are many techniques of aesthetic rhinoplasty but we conclude that the best way to perform it is based in the primary deformity and anatomic peculiarity.  We propose a presentation that shows the diversity of noses in Brazilian population and the long-term overcome of aesthetic rhinoplasty.

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