PRACTICAL SEPTORHINOPLASTY > Plastic Surgery

The discipline of facial plastic surgery has experienced rapid growth in recent years. Teaching of the latest surgical techniques in facial plastic surgery, and in particular, rhinoplasty, has also greatly advanced.
Practical Septorhinoplasty, written by Yong Ju Jang, M.D., and Chan Heum Park,M.D. is a truly excellent textbook which gives the reader the fundamentals of how to perform all aspects of cosmetic and functional rhinoplasty. This comprehensive work details all incisions, approaches, and techniques necessary to perform safe and effective rhinoplasty. An emphasis on details including instrumentation, anesthesia, intraoperative technique, and postoperative care and dressings are detailed.
Dr. Jang has incorporated various aspects of his vast training in Korea and post-residency study in the United States in compiling this truly complete rhinoplasty textbook. It is clear from his results that he is an outstanding technician. More important than his precise technical skills is the ability to effectively communicate his knowledge in this thorough textbook. An emphasis on exact diagnosis of the nasal deformity is present throughout this work. This philosophy illustrates that all augmentation rhinoplasties should not be limited to dissection and placement of an alloplast implant. Rather, the reader is compelled to use a systematic approach including: 1) accurate diagnosis, 2) precise planning, 3) meticulous surgical execution, and 4) empathetic postoperative care. This textbook is an ideal example of the philosophical quote:
"Give a man a fish and he will eat well for a day.
Teach a man to fish and he will eat well for a lifetime."
Practical Septorhinoplasty encourages the reader to be a lifetime rhinoplasty surgeon.
Jonathan Mark Sykes, M.D., FACS
Professor of Otolaryngology
Director, Facial Plastic and Reconstructive Surgery
University of California at Davis Medical Center
Sacramento, California
USA
Foreword
Practical Septorhinoplasty, Dr. Yong Ju Jang, Dr. Chan Heum Park
Dr. Yong Ju Jang and Chan Heum Park has created a magnificent surgical textbook in their work, Practical Septorhinoplasty. They demonstrate clearly the burgeoning interest in Asian rhinoplasty, and the sophistication of techniques they have has acquired to achieve admirable results.
Practical Septorhinoplasty is a thoroughly pragmatic book which informs the rhinoplasty surgeon, from neophyte to expert, of the logical approach to this most demanding operation. The initial chapters on anatomy and physiology are critical for a fundamental understanding of rhinoplasty. As are all of the chapters, they are beautifully and copiously illustrated, this adding immeasurably to the pedagogic value of the text. The chapters on photography, basic instrumentation and preoperative management include necessary advice to build a solid foundation for performing the procedure. It is most important for all surgeons, both head and neck and plastic, to address the functional components of rhinoplasty. These are fully covered before proceeding to the aesthetic details of the procedure.
Dr. Jang and Park review the various deformities the nasal dorsum presents and the technical tools to correct them. It is especially important in treating the Asian nose to comment upon the various grafts and implants available for augmentation. These are compiled in a lucid fashion with well documented illustrations, patient results and worksheet diagrams which enhance our understanding of the maneuvers utilized. The chapters on nasal tip surgery include discussions of alar base deformities and alar-columellar discrepancies and their corrections. These are most important adjunctive procedures, especially in the Asian nose, and provide the reader with logical and clear concept to approach the challenges of the nasal tip with confidence. Dr. Jang and Park complete their treatise by covering specific issues of revision rhinoplasty, nasal fractures and septal perforations, concluding with postoperative management.
The style and format of Practical Septorhinoplasty are crisp and clear. This is especially true of the illustrations, photographs and treatment algorithms which are beautifully presented. The organization of topics is logical and well-delineated, the text concise and easy to read. Each chapter is supported by valuable references for the reader who wishes to explore further. The index affords prompt access to various topics and encourages cross-referencing to areas of interest to the reader.
Practical Septorhinoplasty documents the formidable rhinoplasty expertise of Dr. Jang and Park. It portrays the principles of rhinoplasty and their practical experience in a beautiful and comprehensive textbook. This treatise illustrates the excellence of rhinoplasty in Asia, and around the world. Dr. Jang and Park are to be commended, and appreciated, for their significant contribution to the art and science of contemporary rhinoplasty.
Peter A. Adamson, M.D., F.R.C.S.C., F.A.C.S.
Professor of Otolaryngology
Department of Otolaryngology
Toronto General Hospital
University of Toronto
Toronto, Ontario
Canada
Acknowledgement
The book is dedicated to my loving wife Jeon, Hye Jeong who is a source of constant companionship and a dedicated doctor for whom I have the utmost respect.
- Yong Ju Jang-
I would like to express my appreciation to all the hospital staff members who bore in patience my needless nagging and for their assistance in obtaining the best illustrative photographs possible. Finally, my deepest gratitude goes to my loving wife Eun Ah and son, Jong Heuk for their support and understanding, for sharing in my desire for a book that can be a friend as well as a practical guide and for their forbearance towards the void I created in the family during the course of my writing.
- Chan Heum Park-
Preface
After becoming love-struck with the nose while majoring in Otorhinolaryngology at Seoul National University Hospital, I have been involved in many a nasal surgery since becoming a specialist and a professor of Otorhinolaryngology at Dankook University Hospital in 1996. Among the many forms of nasal surgery, rhinoplasty belongs to a variety of surgery that requires a painstaking approach. From the moment of accepting a patient to actual surgery, it used to be a struggle to find a reference book that was of any practical help. It was thus that I have recollections of spending many an anxious night on the eve of a surgery browsing through several foreign references in the hope of unearthing some helpful tips on certain aspects of the surgery only to discover there was none to be had. In retrospect, therefore, I underwent a most difficult learning curve in the area of rhinoplasty and I must confess that the trial and error I encountered during actual surgery proved to be my best teacher. Fortunately for me, my stay at UC Davis, USA in 2001 as a visiting scholar provided me with an opportunity to observe diverse forms of facial plastic and rhinoplasty surgeries being performed there. This experience proved to be a turning point for me as it prompted me to review my past surgical experiences and establish a new sense of direction for my career as a surgeon. In addition, I believe that the ample clinical experience I was able to encounter since moving to Asan Medical Center in the winter of 2002 proved opportunistic towards elevating myself one step further as a surgeon.
My experience of a rather painful learning process in rhinoplasty prompted me to dream of organizing and publishing in a book the fruit of my curiosity, anxiety and new insights on the subject. In particular, I wished to create a surgical guidebook that would be of practical use for both specialists as well as new colleagues who are about to conduct their first rhinoplasty surgery. The realization of this dream would not have been possible without the partnership of my esteemed colleagues, professor Chan Heum Park and Dr , Tae Woo Koo whom I initially met as student and teacher. I feel extremely privileged to be working with these two doctors. Doctor Park and his fervent enthusiasm for rhinoplasty have infused me with renewed strength and passion. Dr Koo, a gifted rhinoplasty surgeon in his own right, has given us boundless pleasure during the course of our work with his drawings of scientific yet beautiful illustrations.
The intention of this book is unlike that of standard medical textbooks that attempt to thoroughly review innumerable number of medical literature. Rather, the object of this book is to become a “reference book” that provides actual help to doctors faced with the treatment and surgery of patients. The readers, therefore, may, in certain instances, readily discover information that may be novel compared to the knowledge that is often replicated in other textbooks. However, once the reader fully appreciates the artistic aspects of rhinoplasty and the fact that it is an area where diverse theories and practices are possible, he would enjoy this book more fully. The greatest happiness for a doctor is providing happiness to patients. Conversely, there can be no greater pain than to encounter patients who are dissatisfied with the surgical outcome. It is the fervent wish of the authors, therefore, that this book contribute towards the happiness of the patients.
Fall of 2006
Yong Ju Jang

Foreword … iv
Foreword … vi
Acknowledgement … ix
Preface … x
01_ Anatomy for Rhinoplasty … 1
Yong Ju Jang
02_ Physiology for Rhinoplasty … 15
Yong Ju Jang
03_ Digital Photography in Rhinoplasty … 33
Chan Heum Park
04_ Basic Operative Technique and Instruments for Rhinoplasty … 53
Chan Heum Park
05_ Preoperative Management and Anesthesia … 75
Chan Heum Park
06_ Incisions for Rhinoplasty … 85
Yong Ju Jang
07_ Septoplasty for Rhinoplasty … 95
Chan Heum Park
08_ Turbinate Surgery … 125
Chan Heum Park
09_ Dorsal Augmentation … 133
Chan Heum Park
10_ Radix Augmentation … 189
Yong Ju Jang
11_ Osteotomy for Rhinoplasty … 199
Yong Ju Jang
12_ Dorsal Hump Reduction … 221
Yong Ju Jang
13_ Correction of the Deviated Nose … 239
Yong Ju Jang
14_ Surgery of the Nasal Tip … 275
Yong Ju Jang
15_ Alar Base Surgery … 335
Yong Ju Jang
16_ Correction of Alar-Columellar Discrepancies … 351
Yong Ju Jang
17_ Revision Rhinoplasty … 365
Yong Ju Jang
18_ Management of Nasal Bone Fractures … 381
Chan Heum Park
19_ Management of Nasal Septal Perforation … 403
Yong Ju Jang
20_ Postoperative Management … 419
Yong Ju Jang
index … 425

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