← All decks
The first 25 slides, exactly as they appear. The full deck has 153 content slides.
Maxillofacial Surgery
The Nose
Built from Facial Aesthetics — Concepts and Clinical Diagnosis
What’s inside
15 sections · 153 slides
Overview
- Why the nose decides how a face reads
- “
- What this covers
How nose surgery began
From an Egyptian papyrus to modern aesthetic rhinoplasty
- The oldest written record of nasal surgery
- Egyptian papyrus on facial and nasal trauma
- Rebuilding a nose: the Indian method
- The forehead flap
- Forehead flap reconstruction reported in 1794
- How the idea travelled to Europe
- The Italian method of nasal reconstruction
- Carpue, von Graefe and a new word
- From repair to appearance
- The pioneer of modern aesthetic rhinoplasty
- How Joseph's methods spread
- Why patients really ask
- “
- Five moments in the story
The words used to describe the nose
Latin and Greek roots that make the anatomy readable
- Roots worth knowing, part one
- Roots worth knowing, part two
- One term that means the opposite of what it says
How the nose is built
Bone above, cartilage below, and skin that changes as you go
- Two parts, one organ
- The external nose is a pyramid
- What you can see from the outside
- What keeps the outside of the nose open
- The skin is not the same all over
- Feel the skin before you plan
- Bones supporting the upper third of the nose
- The bone and cartilage of the nasal septum
- The cartilages that build the lower nose
- Upper lateral cartilage in detail
- Bones and cartilages of the nose from the side
- The major alar cartilage has two legs
- What anchors the alar cartilage
- Bones and cartilages of the nose seen from below
- Dome, columella and membranous septum
- The nose as three working compartments
Nasal type, index and ethnic variation
Putting names and numbers on the most variable part of the face
- The most variable unit of the face
- Leonardo's profile drawings of nose types
- Nasal index: a number for width
- 65 +/- 5
- How the nasal index is measured
- Classification of nasal type according to nasal index
- Three broad categories of nasal appearance
- Ethnic variation: the ground rules
- Leptorrhine and mesorrhine
- Platyrrhine
- Ethnic variations in nasal type
- When the right answer is not to operate
Landmarks, dimensions and subunits
The vocabulary that makes a nose describable
- Why the nose needs its own direction words
- Direction words used for the nose
- The bridge and its keystone
- Three measurements that get confused
- Nasal height, length and projection
- The nose as an aesthetic unit
- Aesthetic subunits of the nose
- Inside the lobule
- Soft triangles, and where scars hide
Clinical evaluation: the frontal view
Proportions, symmetry, the tip and the alar base
- How to examine a nose
- Vertical proportions, and width against length
- Transverse proportions and the rule of fifths
- Two more widths, and how surgery changes them
- Find asymmetry before surgery, not after
- The midline, and the two alae
- Brow to nasal tip aesthetic line
- Tip-defining points and dome symmetry
- Divergence of the domes and tip bifidity
- Sheen's four tip-defining points
- The gull in flight
- Gull in flight appearance and a hanging columella
- The columella-ala triangle
- Which way the alae point
- Orientation of the lateral alar axis
Profile view: the radix and the nasofrontal angle
Where the nose starts, and how it meets the forehead
- Radix is an area; nasion is a point
- Where nasion sits vertically
- A high nasion versus a low one
- How far forward nasion sits
- Vertical level and forward position of nasion
- Two more references, and how much you can change
- The nasofrontal angle
- Splitting the nasofrontal angle in two
- Nasion, sellion and the nasal starting point
- Nasal starting point: sellion or nasion
- What observers judge attractive: the nasofrontal angle
- When observers wanted surgery
The nasal dorsum and tip rotation
Humps, ski slopes, the supratip break and a useful illusion
- The nasal dorsal line
- Nasal dorsum against the nasal dorsal line
- Hump, ski slope and saddle
- The supratip break
- Nasal tip rotation along an arc
Measuring nasal tip projection
Nine ways to answer one question - and why none is perfect
- What tip projection means
- The nasofacial angle
- The nasofacial angle
- Joseph's profilometer
- What observers judge attractive: the nasofacial angle
- Tip projection compared with upper lip height
- Nasal height to projection ratio
- Nasal projection to nasal length ratio
- Byrd's three linked proportions
- Tip projection against the upper lip position
- Baud's facial circle
- The facial circle, and Leonardo's earlier version
- Leonardo got there first
- Leonardo's square and the nasal base
- Nasal base projection inside Leonardo's square
- One cause of an overprojected tip
Tip angle, tip support and the columella
The lower third of the nose, checked point by point
- The nasal tip angle
- Testing tip support
- The columella double break
- The columellar-lobular angle
- How much columella should show
- The nostril as an oval
- Six columella-alar relationships
The nasolabial angle and the smiling nose
Where the nose hands over to the upper lip
- The nasolabial angle
- Splitting the nasolabial angle in two
- What observers judge attractive: the upper component
- Nasal base inclination
- Assess the nose while the patient smiles
- What happens to the tip when a patient smiles
- Downward displacement of the tip on smiling
The basal view
Looking up at the nose from below
- The ideal shape seen from below
- Assessing the nose from below
- Sizing the tip lobule from below
- Alar flare and the two base widths
- Nostril shape and size
- Nostril types
The nose in the rest of the face
Neighbours change how the same nose looks
- The ideal nose is different for every patient
- The forehead and the brow ridge
- The upper lip
- Nasal growth and orthodontics
- Chin, lips and neck
- Normative values across three populations
- Normative values for adult nasal dimensions and parameters
- Normative values for adult nasal dimensions and parameters (continued)
- What the normative table shows
Nasal function
A rhinoplasty that stops the patient breathing has failed
- What the nose is for
- Form and function travel together
- Two valves regulate nasal airflow
- The internal nasal valve
- The Cottle test
- The external nasal valve
- Septum and turbinates
- Take home: how the nose is built
- Take home: how to assess a nose
- Take home: numbers worth remembering
- Take home: function is half the job
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Facial Aesthetics: Concepts and Clinical Diagnosis, 2nd Edition