Doppler Ultrasonographic Anatomy of the Midline Nasal Dorsum
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ORIGINAL ARTICLE
RHINOPLASTY
Doppler Ultrasonographic Anatomy of the Midline Nasal Dorsum Hyoung-Jin Moon1 • Won Lee2 • Hyun Do Kim3 • Il Hwan Lee3 • Soo Whan Kim3
Received: 23 August 2020 / Accepted: 18 October 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Background This study was performed to identify a safe method for filler injection to prevent blood vessel damage, by means of checking the location and depth of the blood vessels on the midline of the nose using Doppler ultrasonographic imaging. Methods Ultrasonographic images of the nasal areas of patients for filler injection rhinoplasty were reviewed. The location and depth of the dorsal nasal arteries and the intercanthal vein in each part on the midline of the nose were checked. Results The intercanthal vein was detected in the midline of the radix in 22 patients and the midline of the rhinion region in two patients. There were no patients in whom the intercanthal vein was observed in the midline of the supratip region. The dorsal nasal artery was detected in the rhinion region in six patients and in the supratip region in two patients. There were no patients in whom the dorsal nasal artery was observed in the midline of the radix. The dorsal nasal artery was located within 1.2 mm from the perichondrium or periosteum in three patients in whom it was detected in the rhinion. Conclusions When performing dorsal augmentation, the injection of filler into the preperiosteal layer in the rhinion region should be avoided for the prevention of vascular & Soo Whan Kim [email protected] 1
Beup Facial Plastic Surgery Clinic, Seoul, South Korea
2
Yonsei E1 Plastic Surgery Clinic, Anyang, South Korea
3
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul 06591, Korea
embolism. During dorsal augmentation in patients with a nasal hump, the filler can be injected into the preperiosteal space in the radix by introducing a needle perpendicular to the periosteum from the skin. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Ultrasonography Doppler Nose Rhinoplasty Injections Cosmetic techniques
Introduction Rhinoplasty is one of the most commonly performed operations in the field of cosmetic surgery in Asia, because Asians generally have a flat nasal bridge and underprojected nasal tip. However, rhinoplasty using implants and autologous grafts involves a long recovery time, is expensive, and is associated with morbidity and many complications. Therefore, many patients hesitate to undergo this surgery; they would prefer a simpler and cheaper procedure with fewer side effects and a shorter recovery period [1]. Rhinoplasty using f
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