“Comprehensive Rhinoplasty: Structural and Preservation Concepts” by Sam P. Most

Reviewing the book “Comprehensive Rhinoplasty: Structural and Preservation Concepts” by Sam P. Most was a pleasure. This book provides an accessible and enjoyable reading experience toward both rhinoplasty philosophies: structural and preservation.

The book starts with a chapter that highlights the crucial role of nasal hump anatomy in dorsal preservation rhinoplasty, with a special focus on the innovative modified subdorsal strip method MSSM. Chapter 2 offers a comprehensive perspective on photography and its equipment while providing practical guidance on incorporating Photoshop into daily practice. Chapter 3 encompasses the assessment of patients, including psychoemotional evaluation and a detailed exploration of the SCHNOS questionnaire as a valuable preoperative assessment tool. It also offers an in-depth physical examination, facial analysis, and a novel approach to functional evaluation, distinguishing between static and dynamic obstructions rather than traditional internal and external valve terminology, all complemented by a unique classification system for lateral wall insufficiency. In Chapter 4, the authors provide a personal comprehensive, step-by-step account of the rhinoplasty surgical process, offering valuable details, from preoperative preparation to the surgical procedure and postoperative care.

Chapter 5 unveils the refined technique of modified extracorporeal septoplasty, focusing on the nasal septum. In Chapter 6, a comprehensive examination of bony nasal vault osteotomies offers a global perspective. Chapter 7 enriches your understanding of structural dorsal hump reduction, featuring well-illustrated cases and in-depth insights into component reduction. In Chapter 8, discover the elegant nuances of open structural preservation rhinoplasty, including dorsal preservation and its septal variations, and the innovative modified subdorsal strip method, all showcased through video demonstrations. In Chapter 9, the focus is on tip projection and rotation techniques, highlighting the effective use of the tongue-in-groove method, lateral crural overlay, and septal extension graft. In Chapter 10, the focus is on modifying tip volume and geometry. The chapter discusses technical highlights for altering tip volume and geometry, comparing STTE predominant versus cartilaginous predominant tip techniques for each suture and graft method. The content also includes personal advice and valuable tips and tricks aimed at achieving long-lasting results.

In Chapter 11, they introduce the complexities of revision rhinoplasty and the tetrapod complex, paving the way for Part III. Chapter 12 delves into nasal dorsum reconstruction, specifically addressing dorsal augmentation for underprojected noses emphasizing the need for a stable foundation. The chapter explores onlay grafting techniques—both autologous and homologous—weighing their respective pros and cons. Chapter 13 delves into dermatological insights, offering tips to prevent skin issues and exploring techniques for restoring thinned skin. The chapter concludes with a focus on reconstructing the nasal external lining, employing the paramedian forehead flap.

In Chapter 14, titled “Asymmetric Noses,” the authors delve into the complexities of addressing asymmetry, providing readers with valuable tools tailored for each specific site of imbalance. Moving on to Chapter 15, “The Non-Caucasian Nose,” the focus shifts to noses of black, Hispanic, and Asian individuals. This chapter explores the variations and shared objectives within each ethnic group, accompanied by corresponding techniques for enhancement. Chapter 16, aptly named “Grafts in Rhinoplasty,” serves as a practical guide to grafts. The authors categorize grafts based on their source, detailing the methods for harvesting and effective utilization.

Part V of the book delves into five well-illustrated case studies. Two of these focus on primary rhinoplasties, providing detailed insights into component hump reduction and dorsal preservation. The remaining three case studies center around revision cases, addressing challenges such as a saddle nose, nasal lengthening, and nasal shortening.

In conclusion, this book offers a delightful reading experience, enriched with invaluable tips and tricks generously shared by the senior author. I highly recommend this book to young as well as experienced surgeons of all levels and experience, as there is something very valuable to be gained by everyone in this book.

Publication History

Article published online:
11 May 2024