Download PDF
Facial Plast Surg 2024; 40(01): 093-100
DOI: 10.1055/a-2098-6366
Original Research

The Fish Bone Technique: An Innovative Approach for the Bony Nasal Pyramid

Lessandro Martins
1   Brazilian Association of Otorhinolaryngology and Brazilian Academy of Facial Plastic Surgery, Private Office, Sao Paulo, Parana, Brazil
,
Marina Serrato Coelho Fagundes
1   Brazilian Association of Otorhinolaryngology and Brazilian Academy of Facial Plastic Surgery, Private Office, Sao Paulo, Parana, Brazil
,
Heloisa Nardi Koener
1   Brazilian Association of Otorhinolaryngology and Brazilian Academy of Facial Plastic Surgery, Private Office, Sao Paulo, Parana, Brazil
,
Nabil Fakih-Gomez 
2   Department of Facial Plastic & Cranio-Maxillo-Facial Surgery, Fakih Hospital, Lebanon
,
Alwyn R. D'Souza
3   University Hospital Lewisham, London, United Kingdom
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Among many contributions to the world of art and science, Renaissance artist Leonardo da Vinci created the technique known as sfumato. In this technique, da Vinci considered that the regions to be highlighted should be lit up, while the regions to be hidden should be darkened. Drawing parallel with the face, we can work on the anatomical structures underlying the skin and create a favorable surface anatomy for the entire face, including the nose. However, to achieve the ideal hourglass shape of the nose, the bones must be shaped, and a variety of osteotomies are described and used to achieve this. The new and innovative Fish Bone technique, described in this article, allows for the bony nasal pyramid to be shaped and adapted to the hourglass shape, resulting in a harmonious contour, with smooth transitions and preservation airway.

Keywords

rhinoplasty - osteotomy - nasal surface aesthetics - nasal bone - Fish Bone


Publication History

Accepted Manuscript online:
24 May 2023

Article published online:
10 July 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Toriumi DM, Checcone MA. New concepts in nasal tip contouring. Facial Plast Surg Clin North Am 2009; 17 (01) 55-90 , vi
    CrossrefPubMedGoogle Scholar
  • 2 Çakir B, Doğan T, Öreroğlu AR, Daniel RK, Daniel R. Rhinoplasty: surface aesthetics and surgical techniques. Aesthet Surg J 2013; 33 (03) 363-375
    CrossrefPubMedGoogle Scholar
  • 3 Sheen JH, Sheem AP. Aesthetic Rhinoplasty. 2nd ed.. St Louis, MO: CV Mobsy; 1987
    Google Scholar
  • 4 Tardy ME. Rhinoplasty: The Art and the Science. Philadelphia, PA: WB Saunders Co; 1996
    Google Scholar
  • 5 Gryskiewicz JM, Gryskiewicz KM. Nasal osteotomies: a clinical comparison of the perforating methods versus the continuous technique. Plast Reconstr Surg 2004; 113 (05) 1445-1456 , discussion 1457–1458
    CrossrefPubMedGoogle Scholar
  • 6 Most SP, Murakami CS. A modern approach to nasal osteotomies. Facial Plast Surg Clin North Am 2005; 13 (01) 85-92
    CrossrefPubMedGoogle Scholar
  • 7 Harshbarger RJ, Sullivan PK. Lateral nasal osteotomies: implications of bony thickness on fracture patterns. Ann Plast Surg 1999; 42 (04) 365-370 , discussion 370–371
    CrossrefPubMedGoogle Scholar
  • 8 Sullivan PK, Varma M, Rozzelle AA. Optimizing bone-graft nasal reconstruction: a study of nasal bone shape and thickness. Plast Reconstr Surg 1996; 97 (02) 327-335 , discussion 336–337
    CrossrefPubMedGoogle Scholar
  • 9 Krane NA, Markey JD, Moneta LB, Kim MM. Aesthetics of the nasal dorsum: proportions, light, and shadow. Facial Plast Surg 2017; 33 (02) 120-124
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 VanKoevering KK, Rosko AJ, Moyer JS. Osteotomies demystified. Facial Plast Surg Clin North Am 2017; 25 (02) 201-210
    CrossrefPubMedGoogle Scholar
  • 11 Robiony M, Lazzarotto A, Nocini R, Costa F, Sembronio S, Franz L. Piezosurgery: ten years' experience of percutaneous osteotomies in rhinoplasty. J Oral Maxillofac Surg 2019; 77 (06) 1237-1244
    CrossrefPubMedGoogle Scholar
  • 12 Preti G, Martinasso G, Peirone B. et al. Cytokines and growth factors involved in the osseointegration of oral titanium implants positioned using piezoelectric bone surgery versus a drill technique: a pilot study in minipigs. J Periodontol 2007; 78 (04) 716-722
    CrossrefPubMedGoogle Scholar
  • 13 Fallahi HR, Keyhan SO, Fattahi T, Mohiti AK. Comparison of piezosurgery and conventional osteotomy post rhinoplasty morbidities: a double-blind randomized controlled trial. J Oral Maxillofac Surg 2019; 77 (05) 1050-1055
    CrossrefPubMedGoogle Scholar
  • 14 Gerbault O, Daniel RK, Kosins AM. The role of piezoelectric instrumentation in rhinoplasty surgery. Aesthet Surg J 2016; 36 (01) 21-34
    CrossrefPubMedGoogle Scholar
  • 15 Gerbault O, Daniel RK, Kosins AM. Response to “Comments on ‘The role of piezoelectric instrumentation in rhinoplasty surgery’.”. Aesthet Surg J 2016; 36 (05) NP189
    CrossrefPubMedGoogle Scholar
  • 16 Ghassemi A, Prescher A, Talebzadeh M, Hölzle F, Modabber A. Osteotomy of the nasal wall using a newly designed piezo scalpel–a cadaver study. J Oral Maxillofac Surg 2013; 71 (12) 2155.e1-2155.e6
    CrossrefPubMedGoogle Scholar
  • 17 Kim DH, Kang H, Jin HJ, Hwang SH. Effect of piezoelectric osteotomy on postoperative oedema and ecchymosis after rhinoplasty. Clin Otolaryngol 2019; 44 (06) 968-974
    CrossrefPubMedGoogle Scholar