Abstract
Nasal muscles are linked together by an aponeurosis which forms a continuous layer, so-called nasal SMAS, which covers the whole nasal pyramid. In this layer run all the main external nasal vessels. Anatomic analysis of nasal muscles can be performed muscle by muscle so that the function of each muscle can be analyzed from both respiratory and mimic function. This approach explains also the use of botulinum toxin to perform medical rhinoplasty. From the surgical point of view, the plane below the anatomic layer composed by muscles and aponeurosis can be considered the correct plane of undermining, and this layer is very important to protect the skin from the postoperative surgical look. This layer is composed by lateral and medial wings (columellar, alar, septal, and valve) in which the vessels run. Basically, nasal vascularization can be considered as a polygonal multidirectional anastomotic system formed by three transfacial arcades (alar, valve, and radix) connected by longitudinal arteries (angular, dorsal, and intermediate). This vascularization may present anatomic variations depending on patients; anyway, it guarantees all the surgical approaches in nasal surgery.
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References
Testut L (1900) Traité d’Anatomie Humaine, 4th edn. Octave Dom, Paris
Meyer R (2002) Residual bony deformity. Nasofrontal angle. In: Meyer R (ed) Secondary rhinoplasty: including reconstruction of the nose, 2nd edn. Springer, New York, p 68 (Chapter 11)
Redaelli A, Braccini F (2010) Medical rhinoplasty. Basic principles and clinical practice. OEO, Firenze
Saban Y, Andretto AC, Hammou JC, Polselli R (2008) An anatomical study of the nasal superficial musculoaponeurotic system: surgical applications in rhinoplasty. Arch Facial Plast Surg 10(2):109–115
Saban Y, Polselli R (1994) Atlas of surgical anatomy of the face and neck. Masson, Paris
Saban Y, Polselli R (2009) Atlas d’Anatomie Chirurgicale de la Face et du Cou. SEE, Firenze
Pitanguy I, Salgado F, Radwanski HN, Bushkin SC (1995) The surgical importance of the dermocartilaginous ligament of the nose. Plast Reconstr Surg 95(5): 790–794
Sterzi G (1910) Il Tessuto Sottocutaneo (Tela Subcutanea). Niccolai, Firenze
Nakajima H, Imanishi N, Aiso S (2002) Facial artery in the upper lip and nose: anatomy and clinical application. Plast Reconstr Surg 109(3):855–861
Toriumi DM, Mueller RA, Grosch T, Bhattacharyya TK, Larrabee WF Jr (1996) Vascular anatomy of the nose and the external rhinoplasty approach. Arch Otolaryngol Head Neck Surg 122(1):24–34
Jung DH, Kim HJ, Koh KS, Oh CS, Kim KS, Yoon JH, Chung IH (2000) Arterial supply of the nasal tip in Asians. Laryngoscope 110(Pt 2):308–311
Lassau JB, Mitz V, Ricbourg B (1975) Les branches faciales de l’artère faciale. In: Memoires du Laboratoire d’ Anatomie de la Faculté de Paris, Paris
Salmon M (1936) Artères des muscles de la tête et du cou. Ed Masson, Paris, pp 9–75
Taylor GI, Palmer JH (1987) The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg 40(2):113–141
Houseman ND, Taylor GI, Pan WR (2000) The angiosomes of the head and neck: anatomic study and clinical applications. Plast Reconstr Surg 105(7): 2287–2313
Burget GC, Mehick FJ (1985) The subunit principle in nasal reconstruction. Plast Reconstr Surg 76(2): 239–347
Mc Cleve DE, Goldstein JC (1995) Blindness secondary to injections in the nose, mouth and face: cause and prevention. Ear Nose Throat J 74(3):182–188
Sung MS, Kim HG (2010) Ocular Ischemia and ischemic oculomotor nerve palsy after vascular embolization of injectable calcium hydroxyhapatite filler. Ophthal Plast Reconstr Surg 26(4):289–291
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Saban, Y., Amodeo, C.A., Polselli, R. (2013). Muscles, SMAS, and Vascular Anatomy of the Nose. In: Shiffman, M., Di Giuseppe, A. (eds) Advanced Aesthetic Rhinoplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28053-5_1
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DOI: https://doi.org/10.1007/978-3-642-28053-5_1
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