Table Of ContentMiniinvasive Techniques in Rhinoplasty
Edited by Nikolay Serdev
Miniinvasive Techniques in Rhinoplasty
Edited by Nikolay Serdev
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C ontents
Preface
Chapter 1 T-Excision for Nasal Tip Rotation
by Nikolay P. Serdev
Chapter 2 Excision of Prominent Posterior Septal Angle and Nasal Spine
for Downward Tip Rotation, in Short Upper Lip, or Over-Rotated Tip
by Nikolay P. Serdev
Chapter 3 Columella Sliding for Nasal Tip Projection Using
Septocolumellar Transmucosal Mattress Sutures
by Nikolay P. Serdev
Chapter 4 Digital Fracture Versus Lateral Osteotomy
by Nikolay P. Serdev
Chapter 5 Debridement of Lower Lateral Cartilages in Cleft Lip–Nose
Cases along with Management of Skin and Fibrotic Traction
by Nikolay P. Serdev
Chapter 6 Transcutaneous and Transmucosal Serdev Sutures® for Nasal
Tip Refinement, Alar Base Narrowing, and Other Corrections
by Nikolay P. Serdev
Chapter 7 Depressor Septi Nasi Muscle Resection or Nerve Block
by Daniel G. Moina and Gabriel M. Moina
Chapter 8 Sutures or Resection of the Protruding End of Medial Crura
by Daniel G. Moina and Gabriel M. Moina
Chapter 9 Medical Rhinoplasty – The Treatment of Mimical Patients
by Alessio Redaelli
VI Contents
Chapter 10 Botulinum Toxin in the Nasal Area
by Diego Schavelzon, Guillermo Blugerman, Gabriel Wexler and
Lorena Martinez
Chapter 11 Five Fluorouracil, Hyaluronidase, and Triamcinolone in the
Nasal Region
by Guillermo Blugerman, Diego Schavelzon, Lorena Martinez,
Andrés Galfrascoli and Anastasia Chomyszyn
Chapter 12 Auxiliary Procedures in the Nasal Skin
by Diego Schavelzon, Guillermo Blugerman, Roberto Schale,
Anastasia Chomyszyn, Lorena Martínez and Andrés Galfrascoli
Chapter 13 Medical Rhinoplasty – Profile Correction with Resorbable
Fillers
by Alessio Redaelli
Chapter 14 Nonsurgical Rhinoplasty
by Alexander Z. Rivkin
Preface
The first part describes mini-invasive surgical techniques, sufficient
to perform the most important tasks in rhinoplasty, such as: tip
rotation and projection; closure of the open roof after humpectomy;
alignment and stabilization of the columella; refinement of the nasal
tip, lower third and medial third; narrowing of the alar base.
The second part concerns medical rhinoplasty techniques using
nerve blocks, injectable fillers etc., which aim is to achieve similar
results, despite their temporary effect. Currently, the request for
such procedures and their number exceeds this of surgical
operations and demonstrates their importance.
Although minimally invasive techniques will not totally replace
surgical rhinoplasty, this book will serve as a tool to enhance
refinement of rhinoplasty and clinical aesthetics.
This first textbook in minimally invasive rhinoplasty techniques will
be of great help to many doctors and will provoke further
development of time-saving, atraumatic and mini-invasive
techniques with preservative attitude toward nasal tissues in the
modern art of nasal and face beautification.
Chapter 1
T-Excision for Nasal Tip Rotation
Nikolay P. Serdev
Additional information is available at the end of the chapter
http://dx.doi.org/10.5772/62061
Abstract
Authors “T-excision” for nasal tip rotation is used to reduce long noses as an independ‐
ent procedure or as a part of primary or secondary rhinoplasties. It consists of “en bloc”
excision of the cephalic part of the greater alar cartilages and elongated caudal septum,
using: 1) total retrocolumellar incision, prolonged in transcartilaginous incisions, through
opposite nostrils, leaving only skin intact; 2) septal incision, perpendicular to dorsum to
form correct dorsum length, prolonged into intercartilaginous incisions, through opposite
nostrils, leaving only skin intact. Thus, the cephalic strip resection is done en bloc with
the unnecessary excessive and prolonged septum and soft tissue. Two, three mattress
transmucosal septocolumellar sutures for 2–3 weeks are enough to support healing. The
T-excision technique is mini-invasive, nearly bloodless, and time-saving. It is safe; well-
tolerated by patients; there is no pain after surgery; no need of plaster, tampons, and ban‐
dages. Patients can return next day to social life and work.
Keywords: Rhinoplasty, long nose, T-excision en bloc, mini-invasive technique, elongat‐
ed septum, primary or secondary, retrocolumellar incision, transcartilaginous incision,
intercartilaginous incisions, perpendicular to dorsum septal incision, no downtime
1. Introduction
Facial analysis is critical in rhinoplasty. This procedure is not an operation of a separated nose;
it is an artistic surgery to give aesthetic proportions and angles, as well as properly localized
volumes as an aesthetic part of the whole face, which is the goal of beautification. Patient’s
age, sex, skin quality, ethnicity should be considered. Nasal tip position has great importance
in all cases of rhinoplasty and especially in cases of long and nonproportional nose. Cephalic
strip resection of the lower lateral cartilages is performed to achieve upward tip rotation. The
“en bloc” T-excision technique for adjustment of nasal tip involves new understanding of well-
known incisions, based on anatomical knowledge and specific surgical skills. It minimizes
trauma, it is nearly bloodless, achieving acceptable beautifying postoperative result with no
