In this video-based CME activity, Rod J. Rohrich, MD demonstrates an open rhinoplasty on a Latino female patient who presents with a dorsal hump, a drooping nasal tip and slight flaring of the nasal rim. The challenge of this procedure is to make surgical decisions that result in an aesthetically pleasing outcome. The open approach gives the surgeon the ability to inspect the osseocartilaginous framework in its natural state (without tension or distortion) and allows him/her to make a more accurate diagnosis of the cause of external deformity. In addition, due to the exposure that this technique allows, the open approach can make it easier to teach, learn, and perform alterations to the osseocartilaginous framework. Grafts can be placed and sutured so that they do not slip, and the framework structures can be sutured to surrounding structures for further stabilization. Throughout this procedure, Dr. Rohrich demonstrates ongoing assessment and reassessment of his results on the osseocartilaginous framework.
- Plan achievable outcomes for the procedure that meet the patient's goals.
- Perform the incision of the columellar and dissect the tip from the lateral crura and the medial crura to expose the caudal septum.
- Perform a hump reduction to create a natural-looking nose.
- Improve the structural support of the nasal tip and internal nasal valves through the use of cartilage grafts.
- Implement postoperative management strategies to prevent paresthesia, bleeding, and infection.
Accreditation Information
Directly provided by the American Society of Plastic Surgeons® (ASPS®)
Accreditation Statement
The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Designation Statement
The ASPS designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Disclosures
Dr. Rohrich recives royalties from Micrins Instruments and Quality Medical Publishing. He is a recipient with Mentor Corp/Ethicon/Johnson&Johnson. He also receives sponsored research grants from UT Southwestern Medical Center in conjuction with off-label use of injectables in facial soft tissue, is a grant recipient from Neodyne and Hyalco, LLC. All ASPS staff members managing this activity have no relevant financial relationships or affiliations to disclose. All identified conflicts of interest have been resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity, and appropriateness of patient care recommendations. The ASPS also requires faculty/authors to disclose when off-label/unapproved uses of a product are discussed in a CME activity or included in related materials.