aestheticsjournal.com
@aestheticsgroup
Aesthetics Journal
Aesthetics
Pronasale: is the most prominent part of the nasal tip.14 Trichion Glabella Nasion Sellion (radix) Supratip break Tip defining point Pronasale Infratip lobule Subnasale Pogonion Mention Cervical point
Figure 2: Useful nasal anatomy surface anatomy
Nasal dorsum: also called the nasal bridge, it refers to the superior surface of the nose. It is made up of the upper two thirds of the nose, the middle cartilaginous part and the upper bony part.14 Alar cartilage: provides the structure and support for the lower third of the nose. This pair of cartilages, also referred to as the lower lateral cartilages, form a domed arch. They make up the nasal tip and columella. The perfect width of the nose should correspond to the intercanthal distance, which is the same as the width of the alar base (Figure 1).14 Nasal tip: is formed at the point where the two curved lower lateral cartilages come together to form the most forward point of the nose. The tip is divided into the tip lobule, supra-tip lobule and infra-tip lobule.14 Nasion: represents the median anterior tip of the naso-frontal suture.14 Radix: is the nasal root that correlates with the upper termination of the nasal bridge at the glabellar base and is a soft tissue landmark that correlates with the deepest point of the nasal bone.14 Rhinion: is the region that correlates with the junction of the bony upper nasal vault with the cartilaginous middle and is usually the typical high point of a nasal bridge hump.14
115o-130o
Nasofabial angle 90o110o Nasofacial angle
36o
Pogonion
Figure 3: Angles of the nose
Sellion (radix) Subnasale
Subnasale: represents the junction between the columella and philtrum.14 Septum: the dividing wall between right and left nasal passages, deviation in this cartilage can cause a rotational deformity.14 Nasofrontal angle: this is the angle formed between the nasal angle and the forehead (glabella) when viewed laterally with the apex correlating with the angle of the superior eyelash line (Figure 3). Ideally, it should be 115-130 degrees, however it is often less in Asian patients. It is commonly corrected in NSR and the dorsum should be raised with respect to the apex of this angle.14 Nasolabial angle: is the angle between the columella and the lip assessed in association with the position of the columella. This is usually more open in females at 105-120 degrees compared to a more obtuse angle in men where 90-105 degrees is normal.14 Arterial Anatomy When performing NSR, it is vital that practitioners know and understand the arterial anatomy of the nose (Figure 4).14 The dorsal nasal artery emerges from the orbit above the medial palpebral ligament and divides into two branches:14
An interesting observation in NSR is that by adding volume to the nose, an NSR is always going to make the nose slightly larger
1. First branch crosses the root of the nose and anastomoses with the angular artery. 2. Second branch runs along the dorsum of the nose laterally supplying its outer surface towards the nasal tip and anastomoses with the contralateral dorsal nasal artery and the lateral nasal artery. The lateral nasal artery arises from the facial artery and is superficial at the piriform recess (top of nasolabial fold); deep injections are a danger to this area. It supplies the alar and dorsal of the nose anastomosing with septal and alar branches.14 The superior labial artery gives off the columellar arteries that run up the columella ending and anastomosing in the tip with branches of the lateral nasal artery.
Reproduced from Aesthetics | Volume 4/Issue 1 - December 2016