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Objectives: To discuss overprojected nasal tips, to overview treatment options, and to introduce a new method of nasal tip modification., Patients and Methods: A retrospective study was conduced on 29 patients who underwent rhinoplasty where the domes crossover technique was employed. Patients were stratified into 3 groups: 18 patients presented with homogeneous overdevelopment of the LLC (nasal tip over projection type 1), 5 patients with predominant over development of the lobular portion of the LLC (nasal tip overprojection type 2), 6 patients with a true Pinocchio-type nose and a predominant overdevelopment of the columellar portion of the LLC (nasal tip overprojection type 3). Before and after photographs were compared to evaluate nasal tip characteristics. Analysis of results was performed by the use of 3 measurements: Goode's ratio, nasofacial angle and lobule-to-columella ratio., Results: Final nasal tip projection, rotation, volume and shape were satisfactory in all cases. No complication was observed during the follow-up period., Conclusion: This new method of nasal tip modification presents the advantage of preserving natural domes, being quick and allowing the achievement of desirable nasal tip projection, rotation, volume and shape. Moreover according to the alar ring concept, the crossover technique preserves the continuity of the inferior cartilaginous arch and gives an excellent support to nasal tip.

Objectives: To define the anatomy of the infra orbital area and assess the possible connections with the facial morphotypes identifying the tears trough. To deduce therapeutic proposition concerning the management of this area in aesthetic medicine or surgery., Methods: Anatomic dissections of 10 fresh specimens not frozen and not formalin. Dissection layer by layer from skin to bones paying special attention to the infra orbital superficial muscles and the distribution of subcutaneous fat., Results: In this study, it was precised the existence of zygomaticus superficialis and levator genae muscles whose variations in the connections with the orbicularis oculi muscle is probably the origin of the diversity of human facial expression. On the other hand, the tear trough seems to depend on different distributions of the anatomical complex formed by these muscles with the subcutaneous fat and skin that covers it. An anatomical classification into three muscle types has been proposed., Conclusion: The main variations between individual facial expression are related to a different muscular anatomy from one subject to another. The myological classical anatomic description, too stereotyped, can not explain those differences. The classification proposed by the authors can differentiate the facial morphotypes in the infra orbital area and offer therapeutic solutions.

Objective: The authors developed an original and simple method of evaluation of the aesthetic lines of the nose adapted to the harmony of the face., Method: Initially based on their experience, the authors propose an evaluation of the nose in 2 stages and 5 sequencies based on the construction of single circuit lines according to various incidences. They checked thereafter the validity of this method on the operative project and on the appreciation of the results of the rhinoplasties., Results: Controlled on several types of faces, the method suggested by the authors proved to be reliable, simple, reproducible., Conclusion: The authors proposed a method of evaluation of the aesthetic lines of the nose integrated to the harmony of the face. This method relies on the construction, in 5 stages, of single circuit lines not requiring any particular material. The artistic method of evaluation of the nose proposed by the authors is very simple. Rapid and immediately usable, it makes it possible to schedule a rhinoplasty in a few minutes. The evaluation of the aesthetic results of the rhinoplasties is also very simple and reproducible. It has moreover the merit to propose a model of teaching making it possible to the rhinoplastician to criticize his results and thus to progress in its technical training and its operational indications.

Objectives: To highlight the morphodynamic anatomical mechanisms that influence the results of rhinoplasty. To present the technical modalities of nasal dorsum preservation rhinoplasties. To determine the optimized respective surgical indications of the two main techniques of rhinoplasty: interruption rhinoplasty versus conservative rhinoplasty., Materials and Methods: Based on anatomical dissections and initial morphodynamic studies carried out on 100 anatomical specimens, a prospective study of a continuous series of 400 patients operated of primary reduction rhinoplasty or septo-rhinoplasty by one of authors (YS) has been undertaken over a period of ten years (1995-2005) in order to optimize the surgical management of the nasal hump. The studied parameters were: (1) surgical safety, (2) quality of early and late aesthetic result, (3) quality of the functional result, (4) ease of the technical realization of a possible secondary rhinoplasty. The other selected criteria were function of the different nasal hump morphotypes and the expressed wishes of the patients., Results: The anatomical and morphodynamic studies made it possible to better understand the role of the "M" double-arch shape of the nose and the role of the cartilaginous buttresses not only as a function but also the anatomy and the aesthetics of the nose. It is necessary to preserve or repair the arche structures of the septo-triangular and alo-columellar sub-units. The conservative technique, whose results appear much more natural aesthetically, functionally satisfactory and durable over the long term, must be favoured in particular in man and in cases presenting a risk of collapse of the nasal valve., Conclusion: The rhinoplastician must be able to propose, according to the patient's wishes and in view of the results of the morphological analysis, the most adapted procedure according to his own surgical training but by supporting conservation of the osteo-cartilaginous vault whenever possible.

A good anatomical knowledge is a pre-requisite to all surgeries. In rhinoplasty, where many steps are performed without visual control and are only guided by palpation, anatomy must be mastered. Based on classical static anatomy and dynamic surgical modifications of the nose, this study analyses anatomical and surgical correlation and reports their technical implications. Correction of the shape of the nose is to be able to conceptualize the underlying skeleton and to program adapted surgical procedure for each case.

Objectives: Contrast between an immutable anatomy and procedures which constantly evolve requires a dynamic vision and knowledge of the surgical anatomy. The surgeon, confronted with the reality of the anatomical risk must regularly re-examine his "basics" in anatomy and adapt them to techniques sometimes very invasive whose aesthetic benefit must be seriously counterbalanced by the operational risk. The authors endeavoured to present the surgical anatomy of the facelifts while insisting on the practical aspects and the concept of the evaluated surgical risk., Method: Based on more than 15 years experience related on the one hand to more than 400 anatomical dissections of the face and the neck and on the other hand on more than 600 lifts of the face and the neck, the authors analyze the various successive plans from the skin toward the deep osseous plan as they are anatomically and as the surgeon meets them. Each one of these plans is presented according to the various anatomical areas while insisting on its anatomical characteristics and its specific surgical risks.