HomeArticles I’ve heard weak or broad cartilages are common in Hispanic noses, particularly in the nasal tip. How are these improved?
Nasal tip cartilages that are weak can be reinforced through a few different methods. One method is to use suturing techniques to strengthen the cartilage. Another method is to take cartilage from the septum and suture the stronger septal cartilage to the weaker nasal tip cartilage…these are called grafts and can be used in various ways, such as columellar strut graft to strengthen nasal tip support and/or lateral crural strut grafts to strengthen the sidewall of the nose. Broad cartilages […]
HomeArticles Is it possible to perform rhinoplasty on a patient of ethnicity to improve the appearance of the nose but still maintain some of the ethnic characteristics?
Yes, it is possible to perform rhinoplasty while maintaining ethnicity. For example, a Middle Eastern female patient with a bump along the bridge of her nose and a wide, bulbous nasal tip may request refinement of the bridge and tip of her nose and a strong desire to avoid an overdone or “operated” appearance. She may prefer a more subtle result. This is a common request of our patients and is something that is […]
HomeArticles Stephen W. Perkins, M.D.*, Rami K. Batniji, M.D.#
*Perkins/Van Natta Center for Cosmetic Surgery, Meridian Plastic Surgery Center, 170 W. 106th Street, Indianapolis, IN 46290, USA. Corresponding author.
sperkins@perkinsvannatta.com
#Batniji Facial Plastic Surgery, 361 Hospital Road, Suite #329, Newport Beach, CA 92663, USA
Introduction
The desire to achieve a more youthful neckline is one of the more common reasons for a patient to seek out facial plastic surgery. At times, the patient would benefit from a proper facelift to address aging changes to the face and neck. However, there are instances when an isolated necklift is indicated. While an individualized approach to the aging […]
HomeArticles Rami K. Batniji, M.D.*, Kamal A. Batniji, M.D., F.A.C.S.#
*Batniji Facial Plastic Surgery, 361 Hospital Road, Suite #329, Newport Beach, CA 92663. Attending, Department of Plastic Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, CA 92663.
#Chairman, Department of Otolaryngology-Head & Neck Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, CA 92663.
*corresponding author: Rami K. Batniji, M.D., 949.650.8882/949.650.2293 (facsimile)
Introduction
The nasal bones are the most commonly fractured bones in the face. Acute nasal fracture may result in both nasal deformity as well as nasal airway obstruction. However, some controversy still surrounds the management of acute nasal fractures, in that a review of the literature […]
HomeArticles FACIAL PLASTIC SURGERY CLINICS OF NORTH AMERICA
Stephen W. Perkins, MD*, Rami K. Batniji, MD
Surgical technique
Discussion
Summary
Acknowledgments
References
Since Hunt’s description of the coronal brow-lift in 1926, many techniques for surgical rejuvenation of the upper third of the face have been described in the literature [1]. Although the coronal forehead-lift has been the standard with which all other techniques have been compared, most surgeons and patients prefer the endoscopic approach to forehead-lifting. The disadvantages of the coronal approach include the potential for poor scarring with a noticeable scar in the temporal recession, alopecia, forehead paresthesia, hypoesthesia or numbness of the scalp which may […]
HomeArticles Stephen W. Perkins, M.D.1 and Rami K. Batniji, M.D.1
ABSTRACT
Blepharoplasty is one of the most common cosmetic surgeries performed on the male patient. Whereas in the past the male patient would present later in life for eyelid surgery to address functional issues, he now presents earlier in life with an interest in aesthetic improvement as the primary motivating factor. This article reviews the approach of the senior author (SWP) to rejuvenation of the lower eyelid complex. Specifically, we discuss the indications for and techniques of the transcutaneous and transconjunctival approaches for blepharoplasty. As well, adjunctive procedures for rejuvenation of the […]
HomeArticles Rami K. Batniji, MD; Edward D. Buckingham, MD; Edwin F. Williams III, MD
Hemangiomas are the most common tumor of infancy and childhood, affecting approximately 10% of infants by the age of 1 year. The diagnosis can nearly always be made by the patient’s history and findings on physical examination. Prior to the classification system outlined by Mulliken and Glowacki, the natural course of hemangiomas was poorly understood and treatment was inconsistent, ranging from benign neglect to deforming surgical intervention. However, with an improved understanding of the natural course of hemangiomas, as well as advances in anesthesia, laser technology, medical […]
HomeArticles Rami K. Batniji, MD; Joseph L. Hutchison, MD; Ravi Dahiya, MD; Samuel L. Lam; Edwin F. Williams III, MD
Background: Expanded polytetrafluoroethylene (ePTFE) and silicone are safe and relatively biocompatible materials.
Objective: To compare, using multiple histologic parameters, the tissue response to a standard silicone soft tissue implant with the response to a modified ePTFE implant. The modified form of ePTFE is reinforced with fluorinated ethylene propylene (FEPRePTFE), which provides increased pliability and material integrity.
Methods: The implants were placed into a subperiosteal pocket over the skull of adult New Zealand white rabbits. At 7, 30, and 90 days after implantation, en […]
HomeArticles
How does skin thickness effect rhinoplasty on Asian patients?
Asian patients typically have very thick skin at the nasal tip. As such, refinement of the nasal tip is a challenge. Also, swelling after surgery may last longer in thicker skinned patients as compared with thinner skinned patients. Some methods to achieve nasal tip refinement in thick skinned patients include suturing techniques and cartilage grafts to the nasal tip.
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HomeArticles
When performing rhinoplasty on African American patients, do you more commonly use an open or closed approach and why?
It depends. If a patient requests refinement of the nasal tip, I typically recommend an external, or open, approach. Through this approach, I have the exposure necessary for me to perform the maneuvers to achieve reliable, long lasting results to the nasal tip. If the patient requests refinement of the nasal bridge only, I may recommend an endonasal, or closed, approach.
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