Browsing by Author "Milicic, D"
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- Deviated Nose: Partial Lateral Osteotomies in a New Preservation Rhinoplasty ConceptPublication . Sousa Vieira, A; Milicic, D; Torrão Pinheiro, C; Carvalho, GBackground: A deviated nose continues to be a problem to solve in Rhinoplasty. Various techniques were presented as a possible solution of this aesthetic and functional nasal deformation. In the light of current trend of preservation of structures and function, a modification of osteotomies was presented. Goals: The goal of this paper is to present partial lateral osteotomies surgical technique performed with piezo-electric instruments. Methods and Results: Partial and incomplete osteotomies were introduced as method to avoid disinsertion of nasal pyramid of glabellar area and to avoid bony step in areas of osteotomy cut. Rhinosculpture in its extended mode was promoted for modulation of bony structure with obtaining immediate aesthetic and structural results, minoring a surgical trauma. Conclusion: An incomplete oblique transverse, lateral and intermediate osteotomies, facilitates the "slide-down" positioning of the bone edges, without the need of bone dessinsertion in glabellar region.
- Extended Dorsal Preservation in a New Concept of Preservational RhinoplastyPublication . Sousa Vieira, A; Milicic, D; Torrão Pinheiro, C; Carvalho, GBackground: A dorsal preservation rhinoplasty concept was discussed and the benefits vs. contraindications and limitations were presented. In specific cases of severe nasal septal deformations associated with necessity of major septoplasty, focused on perpendicular plate, a New Concept of Extended Dorsal Preservation Rhinoplasty is presented (New Extended PR-D). PR-D is based on septoplasty, rhinosculpture and partial osteotomies. Goals: The objective of this paper is to present a new approach in some cases of rhinoplasty named as extended dorsal preservation rhinoplasty. Methods and Results: Partial and incomplete osteotomies were introduced as method to avoid disinsertion of nasal pyramid of glabellar area and to avoid bony step in areas off osteotomy cut. Rhinosculpture in its extended mode was promoted for modulation of bony structure with obtaining immediate aesthetic and structural results, minoring a surgical trauma. Conclusion: The principles of Preservation Concept were respected in this New Extended PR-D Concept.
- Hybrid Dorsal Preservation Rhinoplasty: How We Do ItPublication . Sousa-Vieira, A; Machado de Carvalho, G; Milicic, DBackground: A difficult to correct dorsal K-area is a frequent cause of residual and/or recurrent dorsal hump in preservation rhinoplasty. Fragile osseocartilaginous elastic connections essential in static stability of nasal pyramid structure should be at least respected. A bulging of Upper Lateral Cartilage (ULC) caudally to this area are principal cause of cartilaginous hump, difficult to correct without damaging the stability. Aim: A hybrid method of a combination of structural surgery with preservation attitude was suggested. Methods and Material: Osseocartilaginous interconnection of DKA area (Dorsal K-Area) can be totally preserved with structural correction of the same area. An incision below of DKA interconnections, with high auto-spreader grafts instead of trimming the deformity was suggested. Conclusion: Septal T-segment could be freely excised as needed, sutured with high and low autospreader graft, as well with septum in desired position, without jeopardizing static stability of nasal pyramid. In our patients, no residual and/or recurrent hump was registered in immediate and as well in long term results