Kosins AM, Obagi ZE. Managing the Difficult Soft Tissue Envelope in Facial and Rhinoplasty Surgery. Aesthet Surg J. 2017 Feb;37(2):143-157. doi: 10.1093/asj/sjw160. Epub 2016 Dec 13. PMID: 27965218.
Staying with the trend I’d like to add this article I published in 2016 with Zein Obagi MD who is a Dermatologist.
In this paper we demonstrate using ultrasound the ability to quantify the thickness of the soft tissue envelope using a validated test. We also present how to treat the different layers of the dermis and subcutaneous tissue. An algorithm is presented.
In addition, the effects of skin conditioning and isotretinoin are quantified using ultrasound. The way we designed this study was I think the best way to get a high level of evidence that was still ethical.
Optimization of the soft tissue envelope (STE) is a new horizon in rhinoplasty as we begin to see that 1/3 of our results are negatively affected by it. Thank you to people like Dean Toriumi and Milos Kovacevic who are pioneering new ways to deal with a damaged STE from prior rhinoplasty.
Aaron Konsins