Middle and upper vault and dorsum paramedian plateau resection is an essential tool in structure, ethnic, custom, revision and reconstructive rhinoplasties, whenever the nasal dorsum upper lateral cartilages feature a thick synchondrosis or fusion with the soft cartilaginous septum and the nasal bones synostosis with the osseous septum is a also a thick fusion one, therefore leads to the so called the reverse spreader graft effect, this is a too broad and flat dorsum, with or without hump, with either too broad middle vault, too broad upper vault or both, with a rectangular (homogeneous plateau), hourglass (upper and lower plateau with narrow middle dorsum) or rhomboid (middle dorsum plateau with narrow radix and supratip) shape.
It is carried out with scalpel parallel to septum resection of the soft cartilaginous middle vault synchondrosis and precision chisel resection of the bony upper synostosis, customized to the specific rectangular, hourglass or rhomboid shape of the plateau, so that an open roof gap between the nasal walls and the septum is achieved, therefore it is mandatory to perform nasal bones infracture osteotomies to close it and prevent deformities requiring revision in the future.
It is considered a highly demanding technique of high difficulty, long consuming in the operating room and pretty much artistic in terms of its versatility, allowing full deployment of creativity reshaping noses.
This gesture can be done by either closed or open approach rhinoplasties, notwithstanding the open approach is a must of safety, reliability and precision for its execution.
Patients warning: only highly experienced surgeons who have underwent optimal training and have performed already a large number of closed and open approach structure and non structure rhinoplasties should execute high end rhinoplasty cases, should they feel capable and comfortable with the challenge.
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DR. ALEJANDRO NOGUEIRA'S DORSUM PLATEAU RESECTION CASES PHOTO GALLERY
BEFORE & AFTER
INTRAOPERATIVE & TECHNICAL
See more accessing Dr. Alejandro Nogueira's entire Dorsum plateau resection Before & After gallery of cases.
See more accessing Dr. Alejandro Nogueira's entire Dorsum plateau resection Intraoperative & Technical gallery of cases.
REVIEWS & RATINGS
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- Medicine and Surgery are not exact sciences, therefore it is not possible to foretell the most likely evolution neither establish the most suitable management for each individual case until the moment the physicians can preoperatively evaluate the patient and receive feedback about the postoperative.
- One surgical process can't be fully predictable or be rigidly scheduled on a previous protocol, so the management plan may be modified at any time based on the requirements that could be considered as necessary or most suitable.
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- Every patient's individual satisfaction is somehow unpredictable, since this will depend on multiple particular, frequently unpredictable and sometimes uncontrollable expectation factors of a very much subjective, cultural, psychological and intellectual kind.
- Even when you feel very similar to another patient in their experience, your grade of satisfaction will likely vary significantly, because you are a unique person and every individual has not only a completely unique psyche, but also uniquely individualistic assessment capacities, expectation tendencies and acceptance processes, some of which are unpredictable even in very well mentally balanced patients who reflect adequately and do all the other right and recommended assessments before and after their procedure.
- All images are genuine, trustworthy and real standard views of the "before" situation and the long term settled "after" actual results of Dr. Alejandro Nogueira’s work, as well as true intraoperative surgical views and authentic technical or clinical scenarios depicting real practice hands-on cases belonging to Dr. Alejandro Nogueira's skills and expertise.
- No other professional but Dr. Alejandro Nogueira himself as leading and executing surgeon has carried out the techniques, procedures and surgeries shown in the galleries.
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- The images of results, treatments, techniques and clinical situations are mere guidance examples aiming to help the patients in their decision-making process, providing an average overview of Dr. Alejandro Nogueira's work; no one of them can be considered as an obligation of any particular results nor a commitment for the application of any specific techniques, therefore you should not base your results expectations on them.
- Every patient has to be assessed individually in order to establish a customized prognosis of results and design an individual surgical plan, being somehow unpredictable the real final outcome of any procedure as well the surgical gestures applied during the intervention, since they will depend on multiple particular, frequently unpredictable and sometimes uncontrollable factors.
- Even when you feel that you look very similar to another patient in their images, your results will likely vary significantly, because you are a unique person and every individual has not only a completely unique physique, but also uniquely individualistic body healing capacities, scarring tendencies and recovery processes, some of which are unpredictable even in very-healthy patients who rest adequately and do all the other right and prescribed things before and after their procedure.
- Previous successful results of a physician do not guarantee future successful procedures and patient's satisfaction.
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