Nuances of Profile Management: The Radix

doi:10.1016/j.fsc.2008.09.007

Facial Plastic Surgery Clinics of North America

Volume 17, Issue 1, February 2009, Pages 15-28

https://doi.org/10.1016/j.fsc.2008.09.007 Get rights and content

Profile refinement is one of the most common reasons patients seek consultation for rhinoplasty. Emphasis on creating a natural-appearing nasal dorsum demands a methodic nasal and facial analysis. Areas of dorsal excess and deficiency are identified, quantitated, and considered when determining surgical goals. The radix is an essential component of the profile and is carefully assessed from the standpoint of projection and position. Height and contour are evaluated at the radix, rhinion, and nasal tip. Each component of the dorsal profile is individually classified as overprojected, underprojected, or of appropriate height. Case studies demonstrate the necessary surgical steps to create a more balanced profile.

Section snippets

Analysis of the nasal profile

The nasal profile consists of the osseocartilagenous dorsum and the nasal tip and their interface with the glabella and subnasale. The profile is defined by its contour, height, length, and interfacing angles. These individual characteristics are not only used to describe the appearance of the profile as a whole but also have a profound impact on each other.

The osseocartilagenous dorsum extends cephalad to the tip-defining point, ending at the nasion. The contour of the dorsal profile should be

Surgical planning

Planning surgical management of the nasal profile begins by determining the ideal configuration of the nasal bridge using the aforementioned aesthetic nasal principles. Height and contour are evaluated at the radix, rhinion, and nasal tip. Each component of the dorsal profile (nasion, rhinion, and tip) is individually classified as overprojected, underprojected, or of appropriate height. To balance the dorsal line, augmentation and reduction of portions of the osseocartilagenous dorsum are in

Case 1

A 27-year-old woman requested reduction of her dorsal convexity (Fig. 7). Profile analysis revealed a deep radix, an overprojected rhinion, and normal tip projection. A deep supratip depression created the illusion of an overprojected tip. Surgical correction included augmentation of the radix and caudal dorsum in the area of the supratip depression and reduction of the rhinion. A double-layered septal cartilage graft was positioned at the radix, and a single piece of septal cartilage was

References (7)

Byrd S, Hobar C. Dimensional rhinoplasty. Plast Reconstr...
Rollin KD. Rhinoplasty....
R.L. Crumley et al.
Quantitative analysis of nasal tip projection
Laryngoscope
(1988)

There are more references available in the full text version of this article.

Cited by (15)

Radix saw: a useful tool for rhinoplasty to correct high radix
2021, Brazilian Journal of Otorhinolaryngology
Citation Excerpt :
The radix defines the most concave part of the cephalic dorsum. The normal distance from the radix to the inner canthus is 6 mm and the distance between the corneal plane and the radix plane is about 9–14 mm.1–4 Radix position is evaluated in the cephalocaudal and anteroposterior axes.
The most difficult aspect of radix lowering is determining the maximum amount of bone that can be removed with osteotomes; here, we describe use of a radix saw, which is a new tool for determining this amount.
In this study, we describe use of a radix saw, which is a new tool to reduce the radix.
The medical charts of 96 patients undergoing surgery to lower a high radix between 2016 and 2017 were assessed retrospectively. All operations were performed by the senior surgeon. Outcomes were assessed by comparing preoperative photographs with the most recent follow-up photographs (minimum of 6 months postoperatively). The photographs were all taken using the same imaging settings, and with consistent subject distance and angulation. The photographs were subsequently analysed by authors.
The study population consisted of 96 patients (70 women, 26 men) who underwent rhinoplasty between 2016 and 2017. The mean age of the patients was 28.8 years (range: 18–50 years) and the mean clinical follow-up period was 1.8 years. No patient required revision surgery due to radix problems, and there were no cases with unwanted bone fragments or radix asymmetry. The swelling and oedema seen immediately after surgery subsided after an average of 7–10 days.
In conclusion, a radix saw can be used for rhinoplasty requiring delicate bone removal in patients with a high radix. Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.
Rhinoplasty: Initial Consultation and Examination
2012, Oral and Maxillofacial Surgery Clinics of North America
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Citation Excerpt :
Patients with a prominent nasal dorsum generally have excesses in both areas. Attempts to reduce the hump may involve rasping, osteotomies, and, rarely, grafting.5 A pollybeak deformity (Fig. 1) is one of the most common reasons for revisional rhinoplasty.
The Ideal Nasion in Chinese: A Preference Analysis of the General Population
2022, Journal of Craniofacial Surgery
Can Procerus Transection Alter the Radix Morphology and Influence the Nasal Length? A Study of Photogrammetric Assessments and Anthropometric Measurements on Asian Patients
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Facial Surface Anthropometric Features and Measurements With an Emphasis on Rhinoplasty
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Nuances of Profile Management: The Radix

Section snippets

Analysis of the nasal profile

Surgical planning

Case 1

Quantitative analysis of nasal tip projection

Laryngoscope