Rhinoplasty

Rhinoplasty, or nose reshaping, both primary and secondary, is a large component of Dr. Yaremchuk's practice. He uses both open and closed techniques as appropriate for the individual needs of the patient. Rhinoplasty can address droopy tip, bulbous tip, dorsal hump, hanging columella, and wide nostrils, among other concerns.
Dr. Yaremchuk's rationale and technique for the use of pyriform aperture augmentation in certain patients was recently published in Clinics in Plastic Surgery: A Multispecialty Approach.  Appropriate for patients with a flat or concave midface, the procedure uses small implants on either side of the nose to create the ideal convex shape of the face: curving outward with the apex at the top lip.


The typical face is convex, curving outward at the midface.

The average angle created by the bottom of the nose and the upper lip is greater than 90 degrees.

Paranasal implants  are inserted to supplement the midface bone structure, elevate the tip of the nose, correct the angle of the upper lip, and minimize the nasolabial fold, also known as laugh lines.

 

 

In patients with a flat or concave midface, the nose appears larger than it would be if the soft tissues next to it were more prominent. Pyriform aperture augmentation can be a useful addition to aesthetic rhinoplasty in patients with this facial shape because it allows a less aggressive surgical approach to the nose while providing an overall better facial balance.  


Pyriform aperture augmentation was used to supplement this patient’s flat midface. After surgery, her face is convex, the nasal tip is elevated, the angle of the upper lip is increased, and the nasolabial fold is less prominent.

before after

* This patient had several rhinoplasties and blepharoplasty in the past. He underwent revision rhinoplasty to deepen his radix and lower his nostril rims, infraorbital rim and midface augmentation, lengthening of his chin by horizontal osteotomy, and mandibular augmentation.

before after

* This patient underwent tertiary rhinoplasty involving osteotomies, spreader grafts, tip refinement and pyriform aperture augmentation.


before after

* This patient underwent primary rhinoplasty with pyriform aperture augmentation

before after

* This patient underwent midface and lower jawskeletal changes in addition to rhinoplasty


before after
before after

* This patient underwent dorsal augmentation as part of her rhinoplasty


before after
before after

before after
before after

before after

* This patient underwent aesthetic rhinoplasty

* Reviews