Invited Discussion on: Surgical Adjuncts to Rhinoplasty: An Algorithmic Approach
- PDF / 199,152 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 54 Downloads / 223 Views
EDITOR’S INVITED COMMENTARY
Invited Discussion on: Surgical Adjuncts to Rhinoplasty: An Algorithmic Approach Jared A. Blau1 • Jeffrey R. Marcus1
Received: 6 May 2020 / Accepted: 18 May 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
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. The article, ‘‘Surgical Adjuncts to Rhinoplasty: An Algorithmic Approach’’, presents a summary of ancillary procedures available to enhance overall aesthetic balance in conjunction with rhinoplasty and an algorithm for when they should be considered [1]. Although the method does not qualify as a systematic review of the literature in the true sense, the authors performed a self-designed literature search for publications that identify procedures as ‘‘adjuncts’’ to rhinoplasty with the intent to share the indications for each. As such, it is largely non-scientific, descriptive in nature, and subject to interpretation. Rhinoplasty must be seen within the context of an overall plan for facial aesthetics and harmony. An adjunct in this context refers to any separate surgical intervention expected to enhance the overall aesthetic and therefore to magnify the impact of the rhinoplasty result. Although a discussion of coexisting facial features may not originate in the patient’s original chief complaint, it is very reasonable to explore the observations as a matter of education and setting expectations [2]. The use of the term ‘‘adjuncts’’ is interesting as it implies that other surgical procedures are of lesser scope, order, or importance to the rhinoplasty procedure. In discussing orthognathic surgery, the authors & Jeffrey R. Marcus [email protected] 1
Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Medical Center, Med Ctr, 142 Brown Zone, Duke South, Box 3974, Durham, NC 27710, USA
shift to characterizing the rhinoplasty as the ‘‘adjunct’’. It is not clear whether their interpretation of ‘‘adjunct’’ suggests simultaneous procedures or staged approaches. Regardless, the value herein is the reminder that one procedure does not achieve total facial balance alone when other imbalances coexist. In fact, nearly any surgical or non-surgical aesthetic intervention could be viewed as a contributor to facial balance and therefore as an ‘‘adjunct’’ to rhinoplasty. A separate but extremely important aspect of this subject, which is not discussed therein, is the issue of sharing observations with a patient who may or may not be aware of coexisting imbalances. What does the patient really see? The surgeon must beware of the situation in which concurrent imbalances preclude the ability of rhinoplasty to achieve the patient’s true goals. The communication of separate but related physical observations along with a suggestion for additi
Data Loading...
