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The “Keystone Angle”: Geometry in Preservation Rhinoplasty

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A Correction to this article was published on 08 April 2024

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Abstract

Rhinoplasty outcome may depend on different factors and bony dorsum shape has proven to significantly influence the lateral view result. The “Keystone angle” corresponds to the osseocartilaginous angle formed between bony and cartilaginous dorsum. Usually, the “V” shaped bony dorsum is characterized by a more acute “Keystone angle” compared to the “S” shaped bony dorsum. To achieve the ideal dorsum flatness, corresponding to a “Keystone angle” of 180°, different techniques may be used. Bearing these concepts in mind we suggest that preoperative assessment of the “Keystone angle” can guide the choice of the most appropriate technique for each patient.

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References

  1. Guyuron B, Wells MW, Chang IA et al (2023) Common dorsal flaws following preservation rhinoplasty: a systemic analysis. Aesth Plast Surg 47:1494–1498. https://doi.org/10.1007/s00266-023-03437-5

    Article  Google Scholar 

  2. Saban Y, de Salvador S (2021) Guidelines for dorsum preservation in primary rhinoplasty. Facial Plast Surg 37(1):53–64. https://doi.org/10.1055/s-0041-1723827. (Epub 2021 Feb 25 PMID: 33634452)

    Article  CAS  PubMed  Google Scholar 

  3. Kosins AM (2021) Incorporating dorsal preservation rhinoplasty into your practice. Facial Plast Surg Clin North Am 29(1):101–111. https://doi.org/10.1016/j.fsc.2020.09.001. (PMID: 33220835)

    Article  PubMed  Google Scholar 

  4. Lazovic GD, Daniel RK, Janosevic LB, Kosanovic RM, Colic MM, Kosins AM (2015) Rhinoplasty: the nasal bones—anatomy and analysis. Aesthet Surg J 35(3):255–263. https://doi.org/10.1093/asj/sju050. (PMID: 25805278)

    Article  PubMed  Google Scholar 

  5. Goksel A, Saban Y, Tran KN (2021) Biomechanical nasal anatomy applied to open preservation rhinoplasty. Facial Plast Surg 37(1):12–21

    Article  CAS  PubMed  Google Scholar 

  6. Gonçalves Ferreira M, Ishida LC, Ishida LH, Santos M (2022) Ferreira-Ishida technique: spare roof technique B. Step-by-step guide to preserving the bony cap while dehumping. Plast Reconstr Surg 149(5):901e-904e. https://doi.org/10.1097/PRS.0000000000009060. Epub 2022 Apr 26. PMID: 35472049.

    Article  PubMed  Google Scholar 

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Correspondence to Annachiara Cavaliere.

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Nele, G., Cavaliere, A. & Schonauer, F. The “Keystone Angle”: Geometry in Preservation Rhinoplasty. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-03997-0

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