FOREWORD
M. Eugene Tardy, Jr.
The pioneers of early rhinoplasty in the late nineteenth and early twentieth century would take pleasure in the fact that this complex operation still incorporates the fundamental principles identified by these visionary men. It is doubtful, however, that any among them could have foreseen the remarkable refinements rather routinely employed in the past decade.
Important developments have transformed aesthetic and reconstructive rhinoplasty from a procedure incorporating primarily tissue reduction and sacrifice to one of tissue reorientation and reconstruction. Time and experience combine to teach that the finest and most natural long-term outcomes are those in which less removal of nasal structures is effected, preserving natural form and function. Clearly the best rhinoplasty surgeons are those who think and plan long-term, tailoring the operation to the exact anatomy encountered, carrying out maneuvers designed to maintain control of the healing process. Cartilage grafting procedures, much more common now than in the past, lend unlimited possibilities to nasal contour sculpturing. Conservative preservation of the various components of the nasal framework and skin-subcutaneous tissue layer now reigns as a fundamental cardinal principle of modern rhinoplasty.
For the majority of our predecessors and teachers, the learning process for sophisticated rhinoplasty procedures was a long and arduous process, rooted in trial and error. The past two decades, stimulated by educators skilled in teaching techniques and aided by knowledge gained through anatomical studies and long-term follow-up of patients operated on by various techniques, have borne witness to a significant shortening of the otherwise steep and arduous learning curve to rhinoplasty excellence. Operative television brings the experience and techniques of experts from around the world to the eager learner at the flick of a video control button. The emergence of the open approach to certain difficult rhinoplasty anatomical problems allows the neophyte surgeon an unparalleled opportunity to witness exact relationships and variations in nasal anatomic components. Fresh cadaver dissection experience has clarified surgical concepts of value and disqualified those with questionable outcomes. A plethora of detailed textbooks on rhinoplasty has emerged in the past decade, providing surgical guidance based upon wide experience and careful patient follow-up.
To this veritable explosion of scholarly information, Nolst Trenité and his associate authors have added another valuable link to the puzzle of aesthetic and functional rhinoplasty.
In the expanded second edition of this successful text/atlas new chapters by surgeons of long experience and vision augment fundamental information from the first edition. A companion interactive CD-ROM vividly portrayed operative techniques discussed in the text. Emphasizing throughout the cardinal principles which apply in the overwhelming majority of rhinoplasty procedures, the authors present herein direct and compelling information for the neophyte and experienced surgeon alike. The clear language of the text is complemented by valuable illustrations designed to give the reader the understanding to apply rhinoplasty principles to a variety of anatomical variants encountered.
Throughout, the authors uniformly emphasize coordinated procedures to repair both functional as well as aesthetic deformities and disorders. Strong emphasis is placed on the significant advantages of cartilage autografts in the treatment of both primary and revision surgery, a philosophy that is generally shared by knowledgeable surgeons worldwide. Techniques which occasion less risk of sequelae or significant complication predominate throughout the volume.
This third edition of Rhinoplasty, edited by Gilbert Nolst Trenité and his contributory colleagues expands and enlarges the canons of nasal surgery elegantly demonstrated in the former editions. Six new chapters have been developed, including expanded and detailed discussions of septoplasty, ethnic rhinoplasty, refinements of the open approach, alar batten grafting and an enlarged section on nasal reconstructive techniques. Furthermore, a most valuable addition to the traditionally nicely illustrated written chapters incorporates an interactive DVD containing elements of live surgery, as well as instructive and vivid videoclips of surgical techniques.
Surgeons who share a Jeep interest and passion for the complex operation of rhinoplasty will enjoy the clear, precise and pragmatic approach incorporated herein. Professor Nolst Trenité and associates have produced what they sought to achieve --a vital and practical contemporary guide to rhinoplasty.
M. Eugene Tardy, Jr., M.D. F.A.C.S.
Professor of Clinical Otolaryngology - Head and Neck Surgery Director, Division of Head and Neck Plastic Surgery University of Illinois Medical Center at Chicago
