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Mark B. Constantian/Rhinoplasty: Craft and Magic,2Vols and 4DVD Massachusetts General Hospital Comprehensive Clinical Psychiatry

Mark B. Constantian/Rhinoplasty: Craft and Magic,2Vols and 4DVD
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Mark B. Constantian/Rhinoplasty: Craft and Magic,2Vols and 4DVD

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Rhinoplasty: Craft and Magic,By Mark B. Constantian, MD, 2Vols and 4 DVD, Publication Date Jun 2009  

Volume I




1.      Static Anatomy and Its Impact on Aesthetics  3

  Toward Refinement 4

           Surface Planes and Light Reflexes 5

              Structural Layers of the Nose   9

              Effect of Dorsal Height on Nasal Length 10

              Anatomic Nasal Layers 12

              Bony and Upper Cartilaginous Vaults 15

              Alar Cartilages 29

              Nasal Base: Upper Lip Complex 45


2.      Dynamic Anatomy and Structural Relationships 53

  Why Rhinoplasty 55

  The Dynamic Nose 56

  Two False Assumptions About the Reduction Model 56

  Nasal Equilibrium 63

  Specific Interrelationships 66 

  Dynamism in Practice: Making Noses Longer or Shorter 92


3.      Involving the Right Brain in Rhinoplasty Diagnosis and  Planning 107

  History of Right-Brain Theory and Its Application to Rhinoplasty     108

  Experiencing Right-Brain Shift 110

  Relating Right-Brain Observations to Rhinoplasty Strategy 118

  How the Left Brain Deceives   121


4.      The Anatomy Of Function and How Rhinoplasty Affects the Airway 133

  The Importance of the Airway Component to Cosmetic              Rhinoplasty 134

  Applied Anatomy: Fundamental of Airway Correction in Practice 158


5.      Four Critical Anatomic Variants and “ The Secret of Everything” 187

  Relevance of the problem 188

  Frontal View: Determining the Airway 191

  Lateral View: Determining a Balanced, Straight Profile 208

  A Matched Pair of Problems 232

  Relevance to Clinical Practice 244




6.      Why Rhinoplasty Is Difficult 253

  Rhinoplasty’s Hidden Anatomy 256

  Why I Prefer Endonasal Rhinoplasty 265

  Photography 268


7.      Planning Rhinoplasty: Abstract Concepts and Aesthetics 279

  Theoretical and Practical Aesthetics 280

  The Reality of the Ideal in Facial Analysis 287

  A Nose That Fits the Face 291

  Practical Aesthetics and Parameters for Planning 292

  Three Surface Parameters for Rhinoplasty Planning 300


8.      Planning Rhinoplasty: Applied Concepts and Aesthetics 317

  The Consultation 318

  Specific of the History 320

  Details of the Interview 342

  The Preoperative Examination 342

  Cooperation and Rapport 347

  Discussing and Agreeing on a Plan 348

  Putting Yourself and the Patient on the Same Side 349

  Helping the Patient on the Same Side 349

  The Male Aesthetic 359

  Explaining the Surgical Plan 366

  Showing Your Result in Other Patients 380

  Computer Imaging 380

  Explaining the Risks to Patient and Family 381

  Patient Attitude and Behavior 381

  Revisions 383

  Closing an Unsuccessful Consultation 388


9.      Creating The Preoperative Plan 391

  A Template for Planning 392

  Constructing a Formal Plan 414

  The Preoperative Envelope 415




10.  How to Learn Rhinoplasty 421

  Learning Surgical Judgment 422

  How to Teach Yourself Rhinoplasty 424


11.  Intraoperative Feedback and Technique in Primary

        Rhinoplasty 463

              Rhinoplasty as a Concept 464

              The uniqueness of Rhinoplasty of Rhinoplasty as an

              Operation 465

              Specifics of the Operations 466

              The Operation Iself 478

              Incisions and Planning 478

              Steps in the Operative Sequence 479


12.  Adding Cartilage to the Nose: Why Grafts Are Necessary


  The Logic of Grafting 568

  Selecting and Harvesting Donor Sites in Primary

  Cases 568

  Prioritizing the Specimens 662

  Constructing Specific Grafts in Primary Rhinoplasty  



13.  The Uncomplicated Postoperative Course 735

  Value of the Postoperative Period to the Surgeon 736

  Early Postoperative Instructions and Management 737

  The First Postoperative Visit 737

  Typical Postoperative Changes 738

  Typical Early Postoperative Changes 744


14.  Problems in the Postoperative Course 751

  Iatrogenic Airway Obstruction 752

  Skeletal Problems 758

  Soft Tissue Problems 762

  Graft Problems 772

  Septal Perforation 804

  Synechiae 807

  Septal Collapse 808

  Rhinitis 809

  Circulatory Problems 810

  Hemorrhage 815

  Infection 816

  Less Common Complications 819

  Unhappy Patients 821







15.  Common Problems in Anatomy and Proportion 827

  Introduction the Icons 828

  Dorsal deformities 828

  Middle Vault Problems 877

  Tip Problems 892

  Problems of Length and Balance 927

  Problems of Volume 936


16.  Exceptions to the Usual 951

  The Traumatized Nose 952

  Rhinoplasty in Men 974

  Ethnic Rhinoplasty 991

  Older patients 1035

  Think Skin 1052

  Thick Skin 1059

  Rhinoplasty 1067




17.  Theory, Planning, and Technique 1087

  Phenomenology and Diagnosis in Secondary Rhinoplasty  


  Secondary Rhinoplasty Compared With Primary  

  Rhinoplasty 1096

  Applicable Techniques 1102

  Donor Site Depletion 1185


18.  Regional Deformities 1189

  Dorsal Deformities 1191

  Middle Vault Problems

  Nasal Base Problems 1220


19.  Generalized Deformities 1237

  Supratip 1239

  Thick skin and Thin Skin 1260

  Septal Collapse 1270

  Problems of Length and Balance 1292

  Reconstruction in Patients Whit Prostheses 1304

  Cleft Lip Nasal Deformity 1316

  Deformities Resulting From Previous Open Rhinoplasty


  Complex Deformities 1364


20.  Unhappy Patients and Those With Body Dysmorphic

Disorder 1401

  The Problem for Surgeons 1403

  The Link to Relation Trauma 1427

  Trauma, Core Issues, Addictions, and Relational

  Problems 1427

  Relational Addiction 1428

  The Physician Component 1429

  And So the Play Begins 1430

  Evidence from a Patient’s Story 1435

  Narcissism in the Classical Sense: A Factor in Body

  Dysmorphic Disorder 1442

  The Incidence of Body Dysmorphic Disorder in Private

  Practice 1444

  A Survey of 1000 Consecutive Rhinoplasty Patients 1446

  Putting It All Together 1447

  Who, Then, Are the Surgical Candidates? 1448



Volume I


DVD 1 Primary Rhinoplasty With Lateral Crural Relocation

DVD 2 Rib Harvesting and Perichondrial/Cartilage Strip

               Rib Graft Harvesting, Perichondrial/Cartilage Strip, and



Volume II


DVD 3 Secondary Rhinoplasty with Composite Grafts and Maxillary

DVD 4 Secondary Rhinoplasty with Ear Cartilage







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