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International formation vanity surgery society, Germany, Berlin

The role of glabella augmentation for Oriental rhinoplasty

Keizo Fukuta, M.D.
Haruo Oguchi, M.D.
Yuji Nakanishi, M.D.
Verite Clinic

Background

The most common demand in rhinoplasty for Orientals is augmentation of the dorsum. Insertion of a silicone implant has been widely used for this purpose.

The dorsal augmentation increases the height of the dorsal line. At the same time, it shifts the nasion to more cephalic position. This means the dorsal augmentation alone can make the nose look longer.

Thus, the dorsal augmentation may create an impression of nose being too long for those who have low dorsum with the nasion in an adequate or cephalic position.

In contrast, the augmentation of the glabella can shift the nasion caudally. This paper presents our experience with use of glabella augmentation.

Materials & Methods

A simple method for the glabella augmentation is injection of hyaluronic acid. Although the result is temporary, it is a very intuitive technique.

For those who seek for a permanent result, we have used a PTFE implant, which is inserted via endonasal approach or open rhinoplasty approach. The upper margin of the implant should be wider than the lower margin.

The width of the lower margin of the glabella implant is to be the same as that of the dorsal line. The width of the upper margin varies from 1.5 cm to 4 cm depending on request.

The folded implant is inserted into the subperiosteal pocket and unfolded using guided percutaneous sutures. The splint is applied for 1 week.

3 patients who had a history of nasal dorsal augmentation underwent the insertion of glabella implant alone. The augmentation of the glabella and nasal dorsum was combined in 25 patients.

Results

The combination of the dorsal augmentation and glabella augmentation resulted in enhancement of the nasal ridge from the eye brow to the nasal tip in the front view.

On the profile, the nasion was maintained at the level between the upper eyelid margin and pupil

Conclusion

It is important to take into account the projection of the glabella and nasal root and the position of the nasion in case of augmentation rhinoplasty.

The use of glabella augmentation can avoid an impression of the nose being too long while enhancing the nasal ridge.

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