Dome Division: A Viable Technique Today? 2016

Armando Boccieri, and Sebastiano Sciuto, and Valerio Cervelli, and Michele Pascali
Department of Facial Plastic Surgery, "Nostra Signora della Mercede" Hospital, Rome, Italy.

Dome division can still be regarded as a valid surgical procedure today in some particular cases of revision rhinoplasty where the scarring is so extensive as to make precise isolation of the alar cartilages impossible. The presence of asymmetry of the nasal tip, a recurrent feature in the results of rhinoplasty, constitutes the primary indication, as division makes it immediately possible to restore balance between the two domes in such cases. The technique also proves useful in cases of overprojection of the tip as a result of rhinoplasty. Moreover, the procedure has been improved by precise suturing of the cartilaginous stumps so as to avoid its frequently reported complications, arising essentially from the vulnerability of the domal arch to the distorting forces of cicatricial retraction and its resulting lack of stability over time. In this connection, the authors attach crucial importance to direct suturing of the cartilaginous stumps in accordance with a now standardized method that is easy to execute and offers lasting, stable results. This approach makes it possible to re-establish continuity of the cartilaginous domal arch in a form unquestionably closer to the physiological anatomical conformation.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009667 Nose Deformities, Acquired Abnormalities of the nose acquired after birth from injury or disease. Acquired Nasal Deformities,Nasal Deformities, Acquired,Acquired Nasal Deformity,Acquired Nose Deformities,Acquired Nose Deformity,Nasal Deformity, Acquired,Nose Deformity, Acquired
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D012225 Rhinoplasty A plastic surgical operation on the nose, either reconstructive, restorative, or cosmetic. (Dorland, 28th ed) Rhinoplasties
D013536 Suture Techniques Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES). Suture Technics,Suture Technic,Suture Technique,Technic, Suture,Technics, Suture,Technique, Suture,Techniques, Suture
D055171 Nasal Cartilages Hyaline cartilages in the nose. There are five major nasal cartilages including two lateral, two alar, and one septal. Alar Nasal Cartilages,Lateral Nasal Cartilages,Septal Nasal Cartilage,Alar Nasal Cartilage,Cartilage, Alar Nasal,Cartilage, Lateral Nasal,Cartilage, Nasal,Cartilage, Septal Nasal,Cartilages, Alar Nasal,Cartilages, Lateral Nasal,Cartilages, Nasal,Cartilages, Septal Nasal,Lateral Nasal Cartilage,Nasal Cartilage,Nasal Cartilage, Alar,Nasal Cartilage, Lateral,Nasal Cartilage, Septal,Nasal Cartilages, Alar,Nasal Cartilages, Lateral,Nasal Cartilages, Septal,Septal Nasal Cartilages

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