New Jeddah Clinic Hospital and the Bizrah Clinic, KSA
Bashar Albizrah is a professional surgeon who is specialized in Rhinoplasy (nasal surgeries) & Facial Surgeries. He is the author of the fi rst surgical textbook on Rhinoplasty and facial plastic surgery in the Middle East and Gulf.
The author highly recommends the technique of new double dome creation, scoring, suture fi xation, columellar strut and as indicated tip graft s. It has the most predictable results, because of the preservation of the continuity of the lateral crus and obtaining a strong tripod of conjoined lateral to medial crura supported by columellar and tip graft s, thus reducing very much the possibility of asymmetry, alar collapse, dropped tip, pinching, notching and alar retraction. However, because of the lateral crus marginal incision and lateral crus delivery, there may be unavoidable problems due to wound healing, fi brosis and contracture such as mild notching, pinching alar retraction, collapse, asymmetry and dimpling. In order to avoid even these problems, the author has developed a new technique which is largely based on the Goldman's tip and the I-beam of medial crura but without lateral crus delivery; and lateral crus marginal incisions. Th is is in order to keep an intact alar rim and avoid any problems along the alar rim such as notching, retraction, collapse or asymmetry. Th e author has been applying this technique for the last 14 years. In his opinion, this technique is very useful to achieve tip projection, defi nition and refi nement in the following situations: tip underprojection, short columella, mild tip bulbousity, and in-revision cases. Th e operative technique preoperative and the postoperative results will be fully discussed with timetables, photographs, illustrations and video presentation.