title: Rhinoplasty

text: Rhinoplasty techniques are described in the ancient Indian text "Sushruta samhita" by Sushruta, where a nose is reconstructed by using a flap of skin from the cheek.


title: Rhinoplasty

text: During the Roman Empire (27 BC – 476 AD) the encyclopaedist Aulus Cornelius Celsus ( 25 BC – 50 AD) published the 8-tome "De Medicina" (On Medicine, 14 AD), which described plastic surgery techniques and procedures for the correction and the reconstruction of the nose and other body parts.


title: Rhinoplasty

text: At the Byzantine Roman court of the Emperor Julian the Apostate (331–363 AD), the royal physician Oribasius ( 320–400 AD) published the 70-volume "Synagogue Medicae" (Medical Compilations, 4th century AD), which described facial-defect reconstructions that featured loose sutures that permitted a surgical wound to heal without distorting the facial flesh; how to clean the bone exposed in a wound; debridement, how to remove damaged tissue to forestall infection and so accelerate healing of the wound; and how to use autologous skin flaps to repair damaged cheeks, eyebrows, lips, and nose, to restore the patient's normal visage.


title: Rhinoplasty

text: In Italy, Gasparo Tagliacozzi (1546–1599), professor of surgery and anatomy at the University of Bologna, published "Curtorum Chirurgia Per Insitionem" (The Surgery of Defects by Implantations, 1597), a technico–procedural manual for the surgical repair and reconstruction of facial wounds in soldiers. The illustrations featured a re-attachment rhinoplasty using a biceps muscle pedicle flap; the graft attached at 3-weeks post-procedure; which, at 2-weeks post-attachment, the surgeon then shaped into a nose.


title: Rhinoplasty

text: In Great Britain, Joseph Constantine Carpue (1764–1846) published the descriptions of two rhinoplasties: the reconstruction of a battle-wounded nose, and the repair of an arsenic-damaged nose. (cf. Carpue's operation).


title: Rhinoplasty

text: In Germany, rhinoplastic technique was refined by surgeons such as the Berlin University professor of surgery Karl Ferdinand von Gräfe (1787–1840), who published "Rhinoplastik" (Rebuilding the Nose, 1818) wherein he described 55 historical plastic surgery procedures, and his technically innovative free-graft nasal reconstruction (with a tissue-flap harvested from the patient's arm), and surgical approaches to eyelid, cleft lip, and cleft palate corrections. Dr. von Gräfe's protégé, the medical and surgical polymath Johann Friedrich Dieffenbach (1794–1847), who was among the first surgeons to anaesthetize the patient before performing the nose surgery, published "Die Operative Chirurgie" (Operative Surgery, 1845), which became a foundational medical and plastic surgical text (see strabismus, torticollis). Moreover, the Prussian Jacques Joseph (1865–1934) published "Nasenplastik und sonstige Gesichtsplastik" (Rhinoplasty and other Facial Plastic Surgeries, 1928), which described refined surgical techniques for performing nose-reduction rhinoplasty via internal incisions.


title: Rhinoplasty

text: In the United States, in 1887, the otolaryngologist John Orlando Roe (1848–1915) performed the first modern endonasal rhinoplasty (closed rhinoplasty) and about his management of saddle nose deformities.


title: Rhinoplasty

text: In the early 20th century, Freer, in 1902, and Killian, in 1904, pioneered the submucous resection septoplasty (SMR) procedure for correcting a deviated septum; they raised mucoperichondrial tissue flaps, and resected the cartilaginous and bony septum (including the vomer bone and the perpendicular plate of the ethmoid bone), maintaining septal support with a 1.0-cm margin at the dorsum and a 1.0-cm margin at the caudad, for which innovations the technique became the foundational, standard septoplastic procedure. In 1921, A. Rethi introduced the open rhinoplasty approach featuring an incision to the nasal septum to facilitate modifying the tip of the nose. In 1929, Peer and Metzenbaum performed the first manipulation of the caudal septum, where it originates and projects from the forehead. In 1947, Maurice H. Cottle (1898–1981) endonasally resolved a septal deviation with a minimalist hemitransfixion incision, which conserved the septum; thus, he advocated for the practical primacy of the closed rhinoplasty approach. In 1957, A. Sercer advocated the "decortication of the nose" ("Dekortication des Nase") technique which featured a columellar-incision open rhinoplasty that allowed greater access to the nasal cavity and to the nasal septum.


title: Rhinoplasty

text: The endonasal rhinoplasty was the usual approach to nose surgery until the 1970s, when Padovan presented his technical refinements, advocating the open rhinoplasty approach; he was seconded by Wilfred S. Goodman in the later 1970s, and by Jack P. Gunter in the 1990s. Goodman impelled technical and procedural progress and popularized the open rhinoplasty approach. In 1987, Gunter reported the technical effectiveness of the open rhinoplasty approach for performing a secondary rhinoplasty; his improved techniques advanced the management of a failed nose surgery.


title: Rhinoplasty

text: For plastic surgical correction, the structural anatomy of the nose comprises: A. the nasal soft tissues; B. the aesthetic subunits and segments; C. the blood supply arteries and veins; D. the nasal lymphatic system; E. the facial and nasal nerves; F. the nasal bone; and G. the nasal cartilages.


title: Rhinoplasty

text: To plan, map, and execute the surgical correction of a nasal defect or deformity, the structure of the external nose is divided into nine aesthetic nasal subunits, and six aesthetic nasal segments, which provide the plastic surgeon with the measures for determining the size, extent, and topographic locale of the nasal defect or deformity.


title: Rhinoplasty

text: In turn, the nine aesthetic nasal subunits are configured as six aesthetic nasal segments; each segment comprehends a nasal area greater than that comprehended by a nasal subunit.


title: Rhinoplasty

text: Using the co-ordinates of the subunits and segments to determine the topographic location of the defect on the nose, the plastic surgeon plans, maps, and executes a rhinoplasty procedure. The unitary division of the nasal topography permits minimal, but precise, cutting, and maximal corrective-tissue coverage, to produce a functional nose of proportionate size, contour, and appearance for the patient. Hence, if more than 50 percent of an aesthetic subunit is lost (damaged, defective, destroyed) the surgeon replaces the entire aesthetic segment, usually with a regional tissue graft, harvested from either the face or the head, or with a tissue graft harvested from elsewhere on the patient's body.


title: Rhinoplasty

text: Like the face, the human nose is well vascularized with arteries and veins, and thus supplied with abundant blood. The principal arterial blood-vessel supply to the nose is two-fold: (i) branches from the internal carotid artery, the branch of the anterior ethmoidal artery, the branch of the posterior ethmoidal artery, which derive from the ophthalmic artery; (ii) branches from the external carotid artery, the sphenopalatine artery, the greater palatine artery, the superior labial artery, and the angular artery.


title: Rhinoplasty

text: The external nose is supplied with blood by the facial artery, which becomes the angular artery that courses over the superomedial aspect of the nose. The sellar region (sella turcica, "Turkish chair") and the dorsal region of the nose are supplied with blood by branches of the internal maxillary artery (infraorbital artery) and the ophthalmic arteries that derive from the internal common carotid artery system.


title: Rhinoplasty

text: Internally, the lateral nasal wall is supplied with blood by the sphenopalatine artery (from behind and below) and by the anterior ethmoid artery and the posterior ethmoid artery (from above and behind). The nasal septum also is supplied with blood by the sphenopalatine artery, and by the anterior and posterior ethmoid arteries, with the additional circulatory contributions of the superior labial artery and of the greater palatine artery. These three vascular supplies to the internal nose converge in the Kiesselbach plexus (the Little area), which is a region in the anteroinferior-third of the nasal septum, (in front and below). Furthermore, the nasal vein vascularisation of the nose generally follows the arterial pattern of nasal vascularisation. The nasal veins are biologically significant, because they have no vessel-valves, and because of their direct, circulatory communication to the cavernous sinus, which makes possible the potential intracranial spreading of a bacterial infection of the nose. Hence, because of such an abundant nasal blood supply, tobacco smoking does therapeutically compromise post-operative healing.


title: Rhinoplasty

text: The pertinent nasal lymphatic system arises from the superficial mucosa, and drains posteriorly to the retropharyngeal nodes (in back), and anteriorly (in front), either to the upper deep cervical nodes (in the neck), or to the submandibular glands (in the lower jaw), or into both the nodes and the glands of the neck and the jaw.


title: Rhinoplasty

text: The sensations registered by the human nose derive from the first two branches of cranial nerve V, the trigeminal nerve. The nerve listings indicate the respective innervation (sensory distribution) of the trigeminal nerve branches within the nose, the face, and the upper jaw (maxilla).


title: Rhinoplasty

text: The supply of parasympathetic nerves to the face and the upper jaw (maxilla) derives from the greater superficial petrosal (GSP) branch of cranial nerve VII, the facial nerve. The GSP nerve joins the deep petrosal nerve (of the sympathetic nervous system), derived from the carotid plexus, to form the vidian nerve (in the vidian canal) that traverses the pterygopalatine ganglion (an autonomic ganglion of the maxillary nerve), wherein only the parasympathetic nerves form synapses, which serve the lacrimal gland and the glands of the nose and of the palate, via the (upper jaw) maxillary division of cranial nerve V, the trigeminal nerve.


title: Rhinoplasty

text: In the upper portion of the nose, the paired nasal bones attach to the frontal bone. Above and to the side (superolaterally), the paired nasal bones connect to the lacrimal bones, and below and to the side (inferolaterally), they attach to the ascending processes of the maxilla (upper jaw). Above and to the back (posterosuperiorly), the bony nasal septum is composed of the perpendicular plate of the ethmoid bone. The vomer bone lies below and to the back (posteroinferiorly), and partially forms the choanal opening into the nasopharynx, (the upper portion of the pharynx that is continuous with the nasal passages). The floor of the nose comprises the premaxilla bone and the palatine bone, the roof of the mouth.


title: Rhinoplasty

text: The nasal septum is composed of the quadrangular cartilage, the vomer bone (the perpendicular plate of the ethmoid bone), aspects of the premaxilla, and the palatine bones. Each lateral nasal wall contains three pairs of turbinates (nasal conchae), which are small, thin, shell-form bones: (i) the superior concha, (ii) the middle concha, and (iii) the inferior concha, which are the bony framework of the turbinates. Lateral to the turbinates is the medial wall of the maxillary sinus. Inferior to the nasal conchae (turbinates) is the meatus space, with names that correspond to the turbinates, e.g. superior turbinate, superior meatus, et alii. The internal roof of the nose is composed by the horizontal, perforated cribriform plate (of the ethmoid bone) through which pass sensory filaments of the olfactory nerve (cranial nerve I); finally, below and behind (posteroinferior) the cribriform plate, sloping down at an angle, is the bony face of the sphenoid sinus.


title: Rhinoplasty

text: The cartilaginous septum ("septum nasi") extends from the nasal bones in the midline (above) to the bony septum in the midline (posteriorly), then down along the bony floor. The septum is quadrangular; the upper half is flanked by two triangular-to-trapezoidal cartilages: the upper lateral-cartilages, which are fused to the dorsal septum in the midline, and laterally attached, with loose ligaments, to the bony margin of the pyriform (pear-shaped) aperture, while the inferior ends of the upper lateral-cartilages are free (unattached). The internal area (angle), formed by the septum and upper lateral-cartilage, constitutes the internal valve of the nose; the sesamoid cartilages are adjacent to the upper lateral-cartilages in the fibroareolar connective tissue.


title: Rhinoplasty

text: Beneath the upper lateral-cartilages lay the lower lateral-cartilages; the paired lower lateral-cartilages swing outwards, from medial attachments, to the caudal septum in the midline (the medial crura) to an intermediate crus (shank) area. Finally, the lower lateral-cartilages flare outwards, above and to the side (superolaterally), as the lateral crura; these cartilages are mobile, unlike the upper lateral cartilages. Furthermore, some persons present anatomical evidence of nasal scrolling—i.e., an outward curving of the lower borders of the upper lateral-cartilages, and an inward curving of the cephalic borders of the alar cartilages.


title: Rhinoplasty

text: The form of the nasal subunits—the dorsum, the sidewalls, the lobule, the soft triangles, the alae, and the columella—are configured differently, according to the race and the ethnic group of the patient, thus the nasal physiognomies denominated as: African, platyrrhine (flat, wide nose); Asiatic, subplatyrrhine (low, wide nose); Caucasian, leptorrhine (narrow nose); and Hispanic, paraleptorrhine (narrow-sided nose). The respective external valve of each nose is variably dependent upon the size, shape, and strength of the lower lateral cartilage.


title: Rhinoplasty

text: In the midline of the nose, the septum is a composite (osseo-cartilaginous) structure that divides the nose into two similar halves. The lateral nasal wall and the paranasal sinuses, the superior concha, the middle concha, and the inferior concha, form the corresponding passages, the superior meatus, the middle meatus, and the inferior meatus, on the lateral nasal wall. The superior meatus is the drainage area for the posterior ethmoid bone cells and the sphenoid sinus; the middle meatus provides drainage for the anterior ethmoid sinuses and for the maxillary and frontal sinuses; and the inferior meatus provides drainage for the nasolacrimal duct.


title: Rhinoplasty

text: The internal nasal valve comprises the area bounded by the upper lateral-cartilage, the septum, the nasal floor, and the anterior head of the inferior turbinate. In the narrow (leptorrhine) nose, this is the narrowest portion of the nasal airway. Generally, this area requires an angle greater than 15 degrees for unobstructed breathing; for the correction of such narrowness, the width of the nasal valve can be increased with spreader grafts and flaring sutures.


title: Rhinoplasty

text: The surgical management of nasal defects and deformities divides the nose into six anatomic subunits: (i) the dorsum, (ii) the sidewalls (paired), (iii) the hemilobules (paired), (iv) the soft triangles (paired), (v) the alae (paired), and (vi) the columella. Surgical correction and reconstruction comprehend the entire anatomic subunit affected by the defect (wound) or deformity, thus, the entire subunit is corrected, especially when the resection (cutting) of the defect encompasses more than 50 percent of the subunit. Aesthetically, the nose—from the nasion (the midpoint of the nasofrontal junction) to the columella-labial junction—ideally occupies one-third of the vertical dimension of the person's face; and, from ala to ala, it ideally should occupy one-fifth of the horizontal dimension of the person's face.


title: Rhinoplasty

text: The nasofrontal angle, between the frontal bone and the nasion usually is 120 degrees; the nasofrontal angle is more acute in the male face than in the female face. The nasofacial angle, the slope of the nose relative to the plane of the face, is approximately 30–40 degrees. The nasolabial angle, the slope between the columella and the philtrum, is approximately 90–95 degrees in the male face, and approximately 100–105 degrees in the female face. Therefore, when observing the nose in profile, the normal show of the columella (the height of the visible nasal aperture) is 2 mm; and the dorsum should be rectilinear (straight). When observed from below (worm's-eye view), the alar base configures an isosceles triangle, with its apex at the infra-tip lobule, immediately beneath the tip of the nose. The facially proportionate projection of the nasal tip (the distance of the nose's tip from the face) is determined with the Goode Method, wherein the projection of the nasal tip should be 55–60 percent of the distance between the nasion (nasofrontal junction) and the tip-defining point. A columellar double break might be present, marking the transition between the intermediate crus of the lower-lateral cartilage and the medial crus.


title: Rhinoplasty

text: The Goode Method determines the extension of the nose from the facial surface by comprehending the distance from the alar groove to the tip of the nose, and then relating that measurement (of nasal-tip projection) to the length of the nasal dorsum. The nasal projection measurement is obtained by delineating a right triangle with lines parting from the nasion (nasofrontal juncture) to the alar–facial–groove. Then, a second, perpendicular delineation, that traverses the tip-defining point, establishes the ratio of projection of the nasal tip; hence, the range of 0.55:1 to 0.60:1, is the ideal nasal-tip-to-nasal-length projection.


title: Rhinoplasty

text: 3D simulations and planning can be used to communicate the patients existing deformities, and plan or propose the desired approach. 3-dimensional cameras allow photographic capture, inspection, analysis, and modification to understand the existing nasal anatomy, and communicate a potential result to the patient.


title: Rhinoplasty

text: To determine the patient's suitability for undergoing a rhinoplasty procedure, the surgeon clinically evaluates them with a complete medical history (anamnesis) to determine their physical and psychological health. The prospective patient must explain to the physician–surgeon the functional and aesthetic nasal problems that they have. The surgeon asks about the ailments' symptoms and their duration, past surgical interventions, allergies, drugs use and drugs abuse (prescription and commercial medications), and a general medical history. Furthermore, additional to physical suitability is psychological suitability—the patient's psychological motive for undergoing nose surgery is critical to the surgeon's pre-operative evaluation of the patient.


title: Rhinoplasty

text: The complete physical examination of the rhinoplasty patient determines if he or she is physically fit to undergo and tolerate the physiologic stresses of nose surgery. The examination comprehends every existing physical problem, and a consultation with an anaesthesiologist, if warranted by the patient's medical data. Specific facial and nasal evaluations record the patient's skin-type, existing surgical scars, and the symmetry and asymmetry of the aesthetic nasal subunits. The external and internal nasal examination concentrates upon the anatomic thirds of the nose—upper section, middle section, lower section—specifically noting their structures; the measures of the nasal angles (at which the external nose projects from the face); and the physical characteristics of the naso-facial bony and soft tissues. The internal examination evaluates the condition of the nasal septum, the internal and external nasal valves, the turbinates, and the nasal lining, paying special attention to the structure and the form of the nasal dorsum and the tip of the nose.


title: Rhinoplasty

text: Furthermore, when warranted, specific tests—the mirror test, vasoconstriction examinations, and the Cottle maneuver—are included to the pre-operative evaluation of the prospective rhinoplasty patient. Established by Maurice H. Cottle (1898–1981), the Cottle maneuver is a principal diagnostic technique for detecting an internal nasal-valve disorder; whilst the patient gently inspires, the surgeon laterally pulls the patient's cheek, thereby simulating the widening of the cross-sectional area of the corresponding internal nasal valve. If the maneuver notably facilitates the patient's inspiration, that result is a positive Cottle sign—which generally indicates an airflow-correction to be surgically effected with an installed spreader-graft. Said correction will improve the internal angle of the nasal valve and thus allow unobstructed breathing. Nonetheless, the Cottle maneuver occasionally yields a false-positive Cottle sign, usually observed in the patient affected by alar collapse, and in the patient with a scarred nasal-valve region.


title: Rhinoplasty

text: There is limited evidence that a single dose of corticosteriods decreases oedema and bleeding first two days post operation but the difference is not maintained after this. Swelling and edema can take at least 1-year to diminish. Certain adjuncts, including fat grafting may help quicken the time to edema and bruising resolution.


title: Rhinoplasty

text: The plastic surgical correction of congenital and acquired abnormalities of the nose restores functional and aesthetic properties by the surgeon's manipulations of the nasal skin, the subcutaneous (underlying) cartilage-and-bone support framework, and the mucous membrane lining. Technically, the plastic surgeon's incisional approach classifies the nasal surgery either as an open rhinoplasty or as a closed rhinoplasty procedure. In open rhinoplasty, the surgeon makes a small, irregular incision to the columella, the fleshy, exterior-end of the nasal septum; this columellar incision is additional to the usual set of incisions for a nasal correction. In closed rhinoplasty, the surgeon performs every procedural incision endonasally (exclusively within the nose), and does not cut the columella.


title: Rhinoplasty

text: Except for the columellar incision, the technical and procedural approaches of open rhinoplasty and of closed rhinoplasty are similar; yet closed rhinoplasty procedure features:


title: Rhinoplasty

text: The open rhinoplasty approach affords the plastic surgeon advantages of ease in securing grafts (skin, cartilage, bone) and, most importantly, in securing the nasal cartilage properly, and so better to make the appropriate assessment and remedy. This procedural aspect can be especially difficult in revision surgery, and in rhinoplastic alteration of the thick-skinned "ethnic nose" of the person of color. The study, "Ethnic Rhinoplasty: a Universal Preoperative Classification System for the Nasal Tip" (2009), reports that a nasal-tip classification system, based upon skin thickness, has been proposed to aid the surgeon in determining if an open rhinoplasty or a closed rhinoplasty can best correct the defect or deformity affecting the patient's nose.


title: Rhinoplasty

text: Cause, the open and closed approaches to rhinoplastic correction resolve: (i) nasal pathologies (diseases intrinsic and diseases extrinsic to the nose); (ii) an unsatisfactory aesthetic appearance (disproportion); (iii) a failed primary rhinoplasty; (iv) an obstructed airway; and (v) congenital nose defects and deformities.


title: Rhinoplasty

text: Recently, ultrasonic rhinoplasty which was introduced by Massimo Robiony in 2004 has become an alternative to traditional rhinoplasty. Ultrasonic rhinoplasty uses piezoelectric instruments to reshape atraumatically nasal bones, also known as rhinosculpture. Ultrasonic rhinoplasty uses piezoelectric instruments (scrapers rasps, saws) that affect only the bones and the stiff cartilages through ultrasonic vibrations, as the instruments used in dental surgery. The use of piezoelectric instruments requires a more extended approach than the isial one, allowing to visualize the whole bony vault, to reshape it with rhinosculpture or to mobilize and stabilize bones after controlled osteotomies.


title: Rhinoplasty

text: A rhinoplastic correction can be performed on a person who is under sedation, under general anaesthesia, or under local anaesthesia; initially, a local anaesthetic mixture of lidocaine and epinephrine is injected to numb the area, and temporarily reduce vascularity, thereby limiting any bleeding. Generally, the plastic surgeon first separates the nasal skin and the soft tissues from the osseo-cartilagenous nasal framework, and then reshapes them, sutures the incisions, and applies either an external or an internal stent, and tape, to immobilize the newly reconstructed nose, and so facilitate the healing of the surgical cuts. Occasionally, the surgeon uses either an autologous cartilage graft or a bone graft, or both, in order to strengthen or to alter the nasal . The autologous grafts usually are harvested from the nasal septum, but, if it has insufficient cartilage (as can occur in a revision rhinoplasty), then either a costal cartilage graft (from the rib cage) or an auricular cartilage graft (concha from the ear) is harvested from the patient's body. When the rhinoplasty requires a bone graft, it is harvested from either the cranium, the hips, or the rib cage; moreover, when neither type of autologous graft is available, a synthetic graft (nasal implant) is used to augment the nasal bridge. The main types of grafts to support and reposition the nasal tip (or the central/medial limb of the tripod) are either columellar strut, or the septal extension graft. Both are useful and effective, but the septal extension graft (SEG) is shown to impart greater control, and less changes over time.


title: Rhinoplasty

text: For the benefit of the patient and the physician–surgeon, a photographic history of the entire rhinoplastic procedure is established; beginning at the pre-operative consultation, continuing during the surgical operation procedures, and concluding with the post-operative outcome. To record the "before-and-after" physiognomies of the nose and the face of the patient, the specific visual perspectives required are photographs of the nose viewed from the anteroposterior (front-to-back) perspective; the lateral view (profiles), the worm's-eye view (from below), the bird's-eye view (overhead), and three-quarter-profile views.


title: Rhinoplasty

text: In plastic surgical praxis, the term primary rhinoplasty denotes an initial (first-time) reconstructive, functional, or aesthetic corrective procedure. The term secondary rhinoplasty denotes the revision of a failed rhinoplasty, an occurrence in 5–20 per cent of rhinoplasty operations, hence a revision rhinoplasty. The corrections usual to secondary rhinoplasty include the cosmetic reshaping of the nose because of a functional breathing deficit from an over aggressive rhinoplasty, asymmetry, deviated or crooked nose, areas of collapses, hanging columella, pinched tip, scooped nose and more. Although most revision rhinoplasty procedures are "open approach", such a correction is more technically complicated, usually because the nasal support structures either were deformed or destroyed in the primary rhinoplasty; thus the surgeon must re-create the nasal support with cartilage grafts harvested either from the ear (auricular cartilage graft) or from the rib cage (costal cartilage graft).


title: Rhinoplasty

text: Can be good if performed by an experienced practitioner. As in all plastic surgery procedures, there can be some unpredictability, and biologic systems can heal in different ways.


title: Rhinoplasty

text: In reconstructive rhinoplasty, the defects and deformities that the plastic surgeon encounters, and must restore to normal function, form, and appearance include broken and displaced nasal bones; disrupted and displaced nasal cartilages; a collapsed bridge of the nose; congenital defect, trauma (blunt, penetrating, blast), autoimmune disorder, cancer, intranasal drug-abuse damages, and failed primary rhinoplasty outcomes. Rhinoplasty reduces bony humps, and re-aligns the nasal bones after they are cut (dissected, resected). When cartilage is disrupted, suturing for re-suspension (structural support), or the use of cartilage grafts to camouflage a depression allow the re-establishment of the normal nasal contour of the nose for the patient. When the bridge of the nose is collapsed, rib-cartilage, ear-cartilage, or cranial-bone grafts can be used to restore its anatomic integrity, and thus the aesthetic continuity of the nose. For augmenting the nasal dorsum, autologous cartilage and bone grafts are preferred to (artificial) nose prostheses, because of the reduced incidence of histologic rejection and medical complications.


title: Rhinoplasty

text: The human nose is a sensory organ that is structurally composed of three types of tissue: (i) an osseo-cartilaginous support framework (nasal skeleton), (ii) a mucous membrane lining, and (iii) an external skin. The anatomic topography of the human nose is a graceful blend of convexities, curves, and depressions, the contours of which show the underlying shape of the nasal skeleton. Hence, these anatomic characteristics permit dividing the nose into nasal subunits: (i) the midline (ii) the nose-tip, (iii) the dorsum, (iv) the soft triangles, (v) the alar lobules, and (vi) the lateral walls. Surgically, the borders of the nasal subunits are ideal locations for the scars, whereby is produced a superior aesthetic outcome, a corrected nose with corresponding skin colors and skin textures.


title: Rhinoplasty

text: Therefore, the successful rhinoplastic outcome depends entirely upon the respective maintenance or restoration of the anatomic integrity of the nasal skeleton, which comprises (a) the nasal bones and the ascending processes of the maxilla in the upper third; (b) the paired upper-lateral cartilages in the middle third; and (c) the lower-lateral, alar cartilages in the lower third. Hence, managing the surgical reconstruction of a damaged, defective, or deformed nose, requires that the plastic surgeon manipulate three anatomic layers:


title: Rhinoplasty

text: The technical principles for the surgical reconstruction of a nose derive from the essential operative principles of plastic surgery: that the applied procedure and yield the most satisfactory functional and aesthetic outcome. Hence, the rhinoplastic reconstruction of a new nasal subunit, of virtually normal appearance, can be done in a few procedural stages, using intranasal tissues to correct defects of the mucosa; cartilage battens to brace against tissue contraction and depression (topographic collapse); axial skin flaps designed from three-dimensional (3-D) templates derived from the topographic subunits of the nose; and the refinement of the resultant correction with the subcutaneous sculpting of bone, cartilage, and flesh. Nonetheless, the physician-surgeon and the rhinoplasty patient must abide the fact that the reconstructed nasal subunit is not a nose proper, but a collagen-glued collage—of forehead skin, cheek skin, mucosa, vestibular lining, nasal septum, and fragments of ear cartilage—which is perceived as a nose only because its contour, skin color, and skin texture are true to the original nose.


title: Rhinoplasty

text: In nasal reconstruction, the plastic surgeon's ultimate goal is recreating the shadows, the contours, the skin color, and the skin texture that define the patient's "normal nose", as perceived at conversational distance (c. 1.0 metre). Yet, such an aesthetic outcome suggests the application of a more complex surgical approach, which requires that the surgeon balance the patient's required rhinoplasty, with the patient's aesthetic ideal (body image). In the context of surgically reconstructing the patient's physiognomy, the "normal nose" is the three-dimensional (3-D) template for replacing the missing of a nose (aesthetic nasal subunit, aesthetic nasal segment), which the plastic surgeon re-creates using firm, malleable, modelling materials—such as bone, cartilage, and flaps of skin and of tissue. In repairing a partial nasal defect (wound), such as that of the alar lobule (the dome above the nostrils), the surgeon uses the undamaged, opposite (contralateral) side of the nose as the 3-D model to fabricate the anatomic template for recreating the deformed nasal subunit, by molding the malleable template material directly upon the normal, undamaged nasal anatomy. To effect a total nasal reconstruction, the template might derive from quotidian observations of the "normal nose" and from photographs of the patient before they sustained the nasal damage.


title: Rhinoplasty

text: The effectiveness of a rhinoplastic reconstruction of the external nose derives from the contents of the surgeon's armamentarium of skin-flap techniques applicable to correcting defects of the nasal skin and of the mucosal lining; some management techniques are the bilobed flap, the nasolabial flap, the paramedian forehead flap, and the septal mucosal flap.


title: Rhinoplasty

text: The design of the bilobed flap derives from the creation of two adjacent random transposition flaps (lobes). In its original design, the leading flap is applied to cover the defect, and the second flap, is emplaced where the skin flexes more, and fills the donor-site wound (from where the first flap was harvested), which then is closed primarily, with sutures. The first flap is oriented geometrically, at 90 degrees from the long axis of the wound (defect), and the second flap is oriented 180 degrees from the axis of the wound. Although effective, the bilobed flap technique did create troublesome "dog ears" of excess flesh that required trimming and it also produced a broad skin-donor area that was difficult to confine to the nose. In 1989, J. A. Zitelli modified the bilobed flap technique by: (a) orienting the leading flap at 45 degrees from the long axis of the wound; and (b) orienting the second flap at 90 degrees from the axis of the wound. Said orientations and emplacements eliminated the excess-flesh "dog ears", and thus required a smaller area of donor skin; resultantly, the broad-based, bilobed flap is less prone to the "trap door" and the "pin cushion" deformities common to skin-flap transposition procedure.


title: Rhinoplasty

text: The design of the bilobed flap co-ordinates its lobes with the long axis of the nasal defect (wound); each lobe of the flap is emplaced at a 45-degree angle to the axis. The two lobes of the bilobed flap rotate along an arc, of which all points are equidistant from the apex of the nasal defect.


title: Rhinoplasty

text: In the 19th century, the surgical techniques of J.F. Dieffenbach (1792–1847) popularized the nasolabial flap for nasal reconstruction, for which it remains a foundational nose surgery procedure. The nasolabial flap can be either superiorly based or inferiorly based; of which the superiorly based flap is the more practical rhinoplastic application, because it has a more versatile arc of rotation, and the donor-site scar is inconspicuous. Depending upon how the defect lay upon the nose, the flap pedicle-base can be incorporated either solely to the nasal reconstruction, or it can be divided into a second stage procedure. The blood supply for the flap pedicle are the transverse branches of the contralateral angular artery (the facial artery terminus parallel to the nose), and by a confluence of blood vessels from the angular artery and from the supraorbital artery in the medial canthus, (the angles formed by the meeting of the upper and lower eyelids). Therefore, the incisions for harvesting the nasolabial flap do not continue superiorly beyond the medial canthal tendon. The nasolabial flap is a random flap that is emplaced with the proximal (near) portion resting upon the lateral wall of the nose, and the distal (far) portion resting upon the cheek, which contains the main angular artery, and so is perfused with retrograde arterial flow.


title: Rhinoplasty

text: The pedicle of the nasolabial flap rests upon the lateral nasal wall, and is transposed a maximum of 60 degrees, in order to avoid the "bridge effect" of a flap emplaced across the nasofacial angle.


title: Rhinoplasty

text: The paramedian forehead flap is the premier autologous skin graft for the reconstruction of a nose, by replacing any of the aesthetic nasal subunits, especially regarding the problems of different tissue thickness and skin color. The forehead flap is an axial skin flap based upon the supraorbital artery (an ophthalmic artery branch) and the supratrochlear artery (an ophthalmic artery terminus), which can be thinned to the subdermal plexus in order to enhance the functional and aesthetic outcome of the nose. Restricted length is a practical application limit of the paramedian forehead flap, especially when the patient has a low frontal hairline. In such a patient, a small portion of scalp skin can be included to the flap, but it does have a different skin texture and does continue growing hair; such mismatching is avoided with the transverse emplacement of the flap along the hairline; yet that portion of the skin flap is random, and so risks a greater incidence of necrosis.


title: Rhinoplasty

text: The paramedian forehead flap has two disadvantages, one operational and one aesthetic: Operationally, the reconstruction of a nose with a paramedian forehead flap is a two-stage surgical procedure, which might a problem for the patient whose health (surgical suitability) includes significant, secondary medical risks. Nonetheless, the second stage of the nasal reconstruction can be performed with the patient under local anaesthesia. Aesthetically, although the flap donor-site scar heals well, it is noticeable, and thus difficult to conceal, especially in men.


title: Rhinoplasty

text: The surgeon designs the paramedian forehead flap from a custom-fabricated three-dimensional metal foil template derived from the measures of the nasal defect to be corrected. Using an ultrasonic scanner, the flap-pedicle is centre-aligned upon the Doppler signal of the supraorbital artery. Afterwards, the distal one-half of the flap is dissected and thinned to the subdermal plexus.


title: Rhinoplasty

text: The septal mucosal tissue flap is the indicated technique for correcting defects of the distal half of the nose, and for correcting almost every type of large defect of the mucosal lining of the nose. The septal mucosal tissue flap, which is an anteriorly based pedicle-graft supplied with blood by the septal branch of the superior labial artery. To perform such a nasal correction, the entire septal mucoperichondrium can be harvested.


title: Rhinoplasty

text: The surgeon cuts the anteriorly based septal mucosal tissue-flap as widely as possible, and then releases it with a low, posterior back-cut; but only as required to allow the rotation of the tissue-flap into the nasal wound.


title: Rhinoplasty

text: A technical variant of the septal mucosal flap technique is the trap-door flap, which is used to reconstruct one side of the upper half of the nasal lining. It is emplaced in the contralateral nasal cavity, as a superiorly based septal mucosal flap of rectangular shape, like that of a "trap-door". This septomucosal flap variant is a random flap with its pedicle based at the junction of the septum and the lateral nasal skeleton. The surgeon elevates the flap of septal mucosa to the roof of the nasal septum, and then traverses it into the contralateral (opposite) nasal cavity through a slit made by removing a small, narrow portion of the dorsal roof of the septum. Afterwards, the septomucosal flap is stretched across the wound in the mucosal lining of the lateral nose.


title: Rhinoplasty

text: The following rhinoplastic techniques are applied to the surgical management of: (i) partial-thickness defects; (ii) full-thickness defects; (iii) reconstruction; and (iv) total nasal reconstruction.


title: Rhinoplasty

text: A partial-thickness defect is a wound with adequate soft-tissue coverage of the underlying nasal skeleton, yet is too large for primary intention closure, with sutures. Based upon the locale of the wound, the surgeon has two options for correcting such a wound: (i) healing the wound by secondary intention (re-epithelialisation); and (ii) healing the wound with a full-thickness skin graft. Moreover, because it avoids the patched appearance of a skin-graft surgical correction, healing by secondary intention can successfully repair nasal wounds up to 10 mm in diameter; and, if the resultant scar proves aesthetically unacceptable, it can be revised later, after the wound has healed.


title: Rhinoplasty

text: In the event, larger nasal wounds (defects) do successfully heal by secondary intention, but do present two disadvantages. First, the resultant scar often is a wide patch of tissue that is aesthetically inferior to the scars produced with other nasal-defect correction techniques; however, the skin of the medial canthus is an exception to such scarring. The second disadvantage to healing by secondary intention is that the contracture of the wound might distort the normal nasal anatomy, which can lead to a pronounced deformity of the alar rim area. For this reason, healing by secondary intention generally is not recommended for defects of the distal third of the nose; nonetheless, the exception is a small wound directly upon the nasal tip.


title: Rhinoplasty

text: Full-thickness skin grafts are the effective wound-management technique for defects with a well-vascularized, soft-tissue bed covering the nasal skeleton. The patient's ear is the preferred skin-graft donor site from which to harvests grafts of pre-auricular skin and grafts of post-auricular skin, usually with an additional, small amount of adipose tissue to fill the wound cavity. Yet, nasal correction with a skin graft harvested from the patient's neck is not recommended, because that skin is low-density pilosebaceous tissue with very few follicles and sebaceous glands, thus is unlike the oily skin of the nose.


title: Rhinoplasty

text: The technical advantages of nasal-defect correction with a skin graft are a brief surgery time, a simple rhinoplastic technique, and a low incidence of tissue morbidity. The most effective corrections are with a shallow wound with sufficient, supporting soft-tissue that will prevent the occurrence of a conspicuous depression. Nonetheless, two disadvantages of skin-graft correction are mismatched skin color and skin texture, which might result in a correction with a patch-work appearance; a third disadvantage is the natural histologic tendency for such skin grafts to contract, which might distort the shape of the corrected nose.


title: Rhinoplasty

text: Full-thickness nasal defects are in three types: (i) wounds to the skin and to the soft tissues, featuring either exposed bone or exposed cartilage, or both; (ii) wounds extending through the nasal skeleton; and (iii) wounds traversing all three nasal layers: skin, muscle, and the osseo-cartilaginous framework. Based upon the dimensions (length, width, depth) and topographic locale of the wound and the number of missing nasal-tissue layers, the surgeon determines the rhinoplastic technique for correcting a full-thickness defect; each of the aesthetic nasal subunits is considered separately and in combination.


title: Rhinoplasty

text: The skin between the nasal dorsum and the medial canthal tendon is uniquely suited to healing by secondary intention; the outcomes often are superior to what is achieved with either skin grafts or skin-flaps and tissue-flaps. Because the medial canthal tendon is affixed to the facial bone, it readily resists the forces of wound contracture; moreover, the animation (movement) of the medial brow also lends resistance to the forces of wound contracture. Furthermore, the medial canthal region is aesthetically hidden by the shadows of the nasal dorsum and of the supraorbital rim, thereby obscuring any differences in the quality of the color and of the texture of the replacement skin (epithelium).


title: Rhinoplasty

text: Healing by secondary intention (re-epithelialisation) occurs even when the wound extends to the nasal bone. Although the rate of healing depends upon the patient's wound-healing capacity, nasal wounds measuring up to 10 mm in diameter usually heal in at 4-weeks post-operative. Nonetheless, one potential, but rare, complication of this nasal correction approach is the formation of a medial canthal web, which can be corrected with two opposing Z-plasties, technique which relieves the disfiguring tensions exerted by the scar tissue's contracture, its shape, and location on the nose.


title: Rhinoplasty

text: The size of the nasal defect (wound) occurred, in either the dorsum or the lateral wall, or both, determines the reconstructive skin-flap technique applicable to the corresponding aesthetic nasal subunits.


title: Rhinoplasty

text: The width of the human nasal-tip ranges 20–30 mm; the average width of the nasal tip, measured between the two alar lobules, is approximately 25 mm.


title: Rhinoplasty

text: The appropriate surgical management of an alar lobule defect depends upon the dimensions (length, width, depth) of the wound. Anatomically, the nasal skin and the underlying soft tissues of the alar lobule form a semi-rigid aesthetic subunit that forms the graceful curve of the alar rim, and provides unobstructed airflow through the nostrils, the "anterior nares".


title: Rhinoplasty

text: The reconstruction rhinoplasty of an extensive defect or of a total nasal defect is an extension of the plastic surgical principles applied to resolving the loss of a regional aesthetic subunit. The skin layers are replaced with a paramedian forehead flap, but, if forehead skin is unavailable, the alternative corrections include the Washio retroauricular-temporal flap and the Tagliacozzi flap. The nasal skeleton is replaced with a rib-graft nasal dorsum and lateral nasal wall; septal cartilage grafts and conchal cartilage grafts are applied to correct defects of the nasal tip and of the alar lobules.


title: Rhinoplasty

text: The nasal lining of the distal two-thirds of the nose can be covered with anteriorly based septal mucosal flaps; however, if bilateral septal-flaps are used, the septal cartilage does become devascularized, possibly from iatrogenic septal perforation. Furthermore, if the nasal defect is beyond the wound-correction scope of a septal mucosal flap, the alternative techniques are either an inferiorly based pericranial-flap (harvested from the frontal bone) or a free flap of temporoparietal fascia (harvested from the head), either of which can be lined with free grafts of mucosa to achieve the nasal reconstruction.


title: Rhinoplasty

text: Illustration 1: The surgeon cuts the excessively wide bones of the upper nasal dorsum (violet) with an osteotome (bone chisel), then detaches, corrects, and relocates them inwards, to a position, between the ocular orbits (red), that narrows the width of the nasal dorsum.


title: Rhinoplasty

text: Illustration 2: The surgeon chisels two cuts (incisions) to the nasal bones, each incision begins at the nasal cavity. The first incision begins at the yellow dot and extends upwards, along the green arrow, until meeting the zig-zag line (red). The second incision begins at the blue dot and extends upwards, along the black arrow, until meeting the zig-zag line (red). Once cut and loosened from the face, the nasal bone pieces are corrected, then pushed inwards and re-set, thus narrowing the nose.


title: Rhinoplasty

text: The rhinoplasty patient returns home after surgery, to rest, and allow the nasal cartilage and bone tissues to heal the effects of having been forcefully cut. Assisted with prescribed medications—antibiotics, analgesics, steroids—to alleviate pain and aid wound healing, the patient convalesces for about 1-week, and can go outdoors. Post-operatively, external sutures are removed at 4–5 days; the external cast is removed at 1-week; the stents are removed within 4–14 days; and the "panda eyes" periorbital bruising heal at 2-weeks. If an alar base reduction is performed conjunctively within the Rhinoplasty, these sutures need to be removed within 7–10 days post operatively. Throughout the first year post-operative, in the course of the rhinoplastic wounds healing, the tissues will shift moderately as they settle into being a new nose.


title: Rhinoplasty

text: Rhinoplasty is safe, yet complications can arise; post-operative bleeding is uncommon, but usually resolves without treatment. Infection is rare, but, when it does occur, it might progress to become an abscess requiring the surgical drainage of the pus, whilst the patient is under general anaesthesia. Adhesions, scars that obstruct the airways can form a bridge across the nasal cavity, from the septum to the turbinates, and require surgical removal. If too much of the osseo-cartilaginous framework is removed, the consequent weakening can cause the external nasal skin to become shapeless, resulting in a "polly beak" deformity, resembling the beak of a parrot. Likewise, if the septum is unsupported, the bridge of the nose can sink, resulting in a "saddle nose" deformity. The tip of the nose can be over-rotated, causing the nostrils to be too visible, resulting in a porcine nose. If the cartilages of the nose tip are over-resected, it can cause a pinched-tip nose. If the columella is incorrectly cut, variable-degree numbness might result, which requires a months-long resolution. Furthermore, in the course of the rhinoplasty, the surgeon might accidentally perforate the septum (septal perforation), which later can cause chronic nose bleeding, crusting of nasal fluids, difficult breathing, and whistling breathing. A turbinectomy may result in empty nose syndrome.


title: Rhinoplasty

text: Non-surgical rhinoplasty is a medical procedure in which injectable fillers, such as collagen or hyaluronic acid, are used to alter and shape a person's nose without invasive surgery. The procedure fills in depressed areas on the nose, lifting the angle of the tip or smoothing the appearance of bumps on the bridge. The procedure does not alter nose size, though it can be used to correct some functional birth defects.


title: Rhinoplasty

text: Originally developed at the turn of the twenty-first century, early attempts used biologically harmful soft-tissue fillers such as paraffin wax and silicone. After 2000, physicians minimally invasive techniques using modern fillers.


title: Madeira wine

text: Madeira is a fortified wine made on the Portuguese Madeira Islands, off the coast of Africa. Madeira is produced in a variety of styles ranging from dry wines which can be consumed on their own, as an apéritif, to sweet wines usually consumed with dessert. Cheaper cooking versions are often flavoured with salt and pepper for use in cooking, but these are not fit for consumption as a beverage.


title: Madeira wine

text: The islands of Madeira have a long winemaking history, dating back to the Age of Exploration (approximately from the end of the 15th century) when Madeira was a standard port of call for ships heading to the New World or East Indies. To prevent the wine from spoiling, neutral grape spirits were added. On the long sea voyages, the wines would be exposed to excessive heat and movement which transformed the flavour of the wine. This was discovered by the wine producers of Madeira when an unsold shipment of wine returned to the islands after a round trip.


title: Madeira wine

text: Today, Madeira is noted for its unique winemaking process which involves oxidizing the wine through heat and ageing. The younger blends (three and five years old) are produced with artificial methods that heat and accelerate the aging process and the older blends, colheitas and frasqueiras are produced by the canteiro method. Because of these methods of production these wines are very long lived and those produced by the canteiro method will survive for decades and even centuries, even after being opened. Wines that have been in barrels for many decades are often removed and stored in demijohns where they may remain unharmed indefinitely.


title: Madeira wine

text: Some wines produced in small quantities in Crimea, California and Texas are also referred to as "Madeira" or "Madera"; however, most countries conform to the EU PDO regulations and limit the use of the term "Madeira" or "Madère" to only those wines that come from the Madeira Islands.


title: Madeira wine

text: The roots of Madeira's wine industry date back to the Age of Exploration, when Madeira was a regular port of call for ships travelling to the East Indies. By the 16th century, records indicate that a well-established wine industry on the island supplied these ships with wine for the long voyages across the sea. The earliest examples of Madeira were unfortified and had the habit of spoiling at sea. However, following the example of Port, a small amount of distilled alcohol made from cane sugar was added to stabilize the wine by boosting the alcohol content (the modern process of fortification using brandy did not become widespread until the 18th century). The Dutch East India Company became a regular customer, picking up large (112 gal/423 L) casks of wine known as "pipes" for their voyages to India.


title: Madeira wine

text: The intense heat in the holds of the ships had a transforming effect on the wine, as discovered by Madeira producers when one shipment was returned to the island after a long trip. The customer was found to prefer the taste of this style of wine, and Madeira labeled as "vinho da roda" (wines that have made a round trip) became very popular. Madeira producers found that aging the wine on long sea voyages was very costly, so they began to develop methods on the island to produce the same aged and heated style. They began storing the wines on trestles at the winery or in special rooms known as "estufas", where the heat of island sun would age the wine.


title: Madeira wine

text: The 18th century was the "golden age" for Madeira. The wine's popularity extended from the American colonies and Brazil in the New World to Great Britain, Russia, and Northern Africa. The American colonies, in particular, were enthusiastic customers, consuming as much as 95% of all wine produced on the island each year.


title: Madeira wine

text: Madeira was a very important wine in the history of the United States of America. No wine-quality grapes were grown among the thirteen colonies, so imports were needed, with a great focus on Madeira. One of the major events on the road to the American Revolution in which Madeira played a key role was the British seizure of John Hancock's sloop on 9 May 1768. Hancock's boat was seized after he had unloaded a cargo of 25 pipes () of Madeira, and a dispute arose over import duties. The seizure of "Liberty" caused riots to erupt among the people of Boston.


title: Madeira wine

text: Madeira was a favorite of Thomas Jefferson, and it was used to toast the Declaration of Independence. George Washington, Alexander Hamilton, Benjamin Franklin and John Adams are also said to have appreciated the qualities of Madeira. The wine was mentioned in Benjamin Franklin's autobiography. On one occasion, Adams wrote to his wife, Abigail, of the great quantities of Madeira he consumed while a Massachusetts delegate to the Continental Congress. A bottle of Madeira was used by visiting Captain James Sever to christen in 1797. Chief Justice John Marshall was also known to appreciate Madeira, as were his cohorts on the early U.S. Supreme Court.


title: Madeira wine

text: The mid-19th century ushered an end to the industry's prosperity. First came the 1851 discovery of powdery mildew, which severely reduced production over the next three years. Just as the industry was recovering through the use of the copper-based Bordeaux mixture fungicide, the phylloxera epidemic that had plagued France and other European wine regions reached the island. By the end of the 19th century, most of the island's vineyards had been uprooted, and many were converted to sugar cane production. The majority of the vineyards that did replant chose to use American vine varieties, such as "Vitis labrusca, Vitis riparia and Vitis rupestris" or hybrid grape varieties rather than replant with the "Vitis vinifera" varieties that were previously grown.


title: Madeira wine

text: By the turn of the 20th century, sales started to slowly return to normal, until the industry was rocked again by the Russian Civil War and American Prohibition, which closed off two of Madeira's biggest markets. After the repeal of Prohibition, improved shipping technology meant that ships no longer needed to stop off in Madeira, the island which was directly in the trade winds between Europe and America. The wine became known as The Forgotten Island Wine. The rest of the 20th century saw a downturn for Madeira, both in sales and reputation, as low quality "cooking wine" became primarily associated with the island—much as it had for Marsala.


title: Madeira wine

text: In 1988, the Symington family of Portugal invested in the Madeira Wine Company which owned many of the Madeira brand names. They asked Bartholomew Broadbent to re-launch Madeira and create a market for it again in America, which he did in 1989, establishing a firm rebirth of Madeira.


title: Madeira wine

text: Towards the end of 20th century, some producers started a renewed focus on quality—ripping out the hybrid and American vines and replanting with the "noble grape" varieties of Sercial, Verdelho, Bual and Malvasia. The "workhorse" varieties of Tinta Negra Mole now known officially as just Tinta Negra, and Complexa are still present and in high use, but hybrid grapes were officially banned from wine production in 1979. Today, Madeira's primary markets are in the Benelux countries, France, where it is entirely used for cooking, salt and pepper having been added prior to bottling, and Germany; emerging markets are growing in Japan, the United Kingdom, and the United States.


title: Madeira wine

text: The island of Madeira has an oceanic climate with some tropical influences. With high rainfall and average mean temperature of 66 °F (19 °C), the threats of fungal grape diseases and botrytis rot are constant viticultural hazards. To combat these threats, Madeira vineyards are often planted on low trellises, known as "latada", that raise the canopy of the vine off the ground similar to a style used in the Vinho Verde region of Portugal. The terrain of the mountainous volcanic island is difficult to cultivate, so vineyards are planted on man-made terraces of red and brown basaltic bedrock. These terraces, known as "poios", are very similar to the terraces of the Douro that make Port wine production possible. The use of mechanical harvesting and vineyard equipment is near impossible, making wine grape growing a costly endeavor on the island. Many vineyards have in the past been ripped up for commercial tourist developments or replanted with such products as bananas for commercial concerns. Some replanting is taking place on the island; however, the tourist trade is generally seen as a more lucrative business than wine-making. Most of the grapes, grown by around 2100 grape growers are from vines planted on small plots of land off of which the grape growers survive by making an income from a variety of different inter-grown crops.


title: Madeira wine

text: Approximately 85% of Madeira is produced with the red grape, Negra Mole. The four major white grape varieties used for Madeira production are (from sweetest to driest) Malvasia, Bual, Verdelho and Sercial. These varieties also lend their names to Madeira labelling, as discussed below. Occasionally one sees Terrantez, Bastardo and Moscatel varieties, although these are now increasingly rare on the island because of oidium and phylloxera. After the phylloxera epidemic, many wines were "mislabelled" as containing one of these noble grape varieties, which were reinterpreted as "wine styles" rather than true varietal names. Since the epidemic, Tinta Negra (or Negra Mole) and Complexa are the workhorse varieties on the island, and are found in various concentrations in many blends and vintage wines. Bastardo, Complexa and Tinta Negra are red grape varieties.


title: Madeira wine

text: Regulations enacted recently by the European Union have applied the rule that 85% of the grapes in the wine must be of the variety on the label. Thus, wines from before the late 19th century (pre-phylloxera) and after the late 20th century conform to this rule. Many "varietally labelled" madeiras, from most of the 20th century, do not. Modern Madeiras which do not carry a varietal label are generally made from Negra Mole.


title: Madeira wine

text: Other varieties planted on the island, though not legally permitted for Madeira production, include Arnsburger, Cabernet Sauvignon, and the American hybrids Cunningham and Jacquet.


title: Madeira wine

text: The initial winemaking steps of Madeira start out like most other wines: grapes are harvested, crushed, pressed, and then fermented in either stainless steel or oak casks. The grape varieties destined for sweeter wines – Bual and Malvasia – are often fermented on their skins to leach more phenols from the grapes to balance the sweetness of the wine. The more dry wines – made from Sercial, Verdelho, and Negra Mole – are separated from their skins prior to fermentation. Depending on the level of sweetness desired, fermentation of the wine is halted at some point by the addition of neutral grape spirits.


title: Madeira wine

text: The younger wines (typically 3 and 5 years old) undergo the "estufagem" aging process to produce Madeira's distinctive flavor by artificial heating, whereas the wines destined for longer aging are barrel-aged using only the naturally high temperatures of the barrel storage rooms (see "canteiro process").


title: Madeira wine

text: Colourings such as caramel colouring have been used in the past to give some consistency (see also whiskey), although this practice is decreasing.


title: Madeira wine

text: What makes Madeira wine production unique is how the wines are aged in relatively high temperatures, meant to duplicate the effect of a long sea voyage on the aging barrels through tropical climates. Three main methods are used to heat the wine during the aging. The two processes belong to the "estufagem" process ("estufa" means hothouse or stove in Portuguese), in which artificial heat is used to accelerate the aging process of the wines, whereas the "canteiro" process is used for the older and more expensive wines and employs only the natural heat of the barrel warehouses.


title: Madeira wine

text: Much of the characteristic flavour of Madeira is due to this practice, which hastens the mellowing of the wine and also tends to check secondary fermentation in as much as it is, in effect, a mild kind of pasteurization. Furthermore, the wine is deliberately exposed to air, causing it to oxidize. The resulting wine has a colour similar to a tawny port wine. Wine tasters sometimes describe a wine which has been exposed to excessive heat during its storage as being cooked or "maderized".


title: Madeira wine

text: The four major styles of Madeira are synonymous with the names of the four best known white grapes used to produce the wine. Ranging from the driest style to the sweetest style, the Madeira types are:


title: Madeira wine

text: A fifth noble grape, "Terrantez", almost became extinct on the island but has been making a comeback. Its style ranges in sweetness from that of Verdelho to that of Bual, never being quite as dry as Sercial nor quite as sweet as Malvasia.


title: Madeira wine

text: Wines made from at least 85% of the noble varieties of Sercial, Verdelho, Bual, and Malvasia are usually labelled based on the amount of time they were aged:


title: Madeira wine

text: A wine labeled as Finest has been aged for at least three years. This style is usually reserved for cooking.


title: Madeira wine

text: Madeira produced from Negra Mole grapes used to be legally restricted to use generic terms on the label to indicate the level of sweetness as "seco" (dry), "meio seco" (medium dry), "meio doce" (medium sweet) and "doce" (sweet). However, in 2015 the Madeira Wine Institute announced that producers may officially recognise Tinta Negra on their front labels, and that all "expressions" must state their bottling date.


title: Madeira wine

text: Wines listed with "Solera" were made in a style similar to sherry, with fractional blending of wines from different vintages in a solera system. The Solera method of blending is most widely practiced in the sherry production of Spain. However, the rules for Madeira soleras are different. When it comes to sherry, as wine is used for bottling, new wine is added to the barrels of older wine and this continuous addition of young wine to old would result in very little wine being from the original vintage. With Madeira, approximately 50% of a bottle would likely be from the stated year because they are only allowed to add up to 10%, not more than 10 times. Another interesting peculiarity of old solera Madeiras is that they were initially developed as a result of trying to extend the stocks of vintages when the vines had stopped being productive due to Phylloxera. Therefore, as there was no younger wine to add to the vintage, it was usually older wines which were added. In recent years, vintage Madeiras have been commanding higher prices than soleras, but, from 1966 (when Michael Broadbent started wine auctions at Christie's), until about the end of the 20th century, solera Madeiras always fetched a premium at auction over the vintage ones.


title: Madeira wine

text: A style called "Rainwater" is one of the largest selling styles of Madeira in the United States. This style of wine is lighter and similar in sweetness to Verdelho, but can be expected to be made from Negra Mole, and is primarily used as an apéritif.


title: Madeira wine

text: Accounts conflict as to how this style was developed. The most common is the name derives from the vineyards on the steep hillsides, where irrigation was difficult, and the vines were dependent on the local rain water for survival. Another theory involves a shipment destined for the American colonies that was accidentally diluted by rainwater while it sat on the docks in Savannah, Georgia or Funchal. Rather than dump the wines, the merchants tried to pass it off as a "new style" of Madeira and were surprised at its popularity among the Americans. Another theory as to how Rainwater was named was when a gentleman in Savannah, Georgia tasted a Madeira and declared "this is as fine as Rainwater."


title: Madeira wine

text: Exposure to extreme temperature and oxygen accounts for Madeira's stability; an opened bottle will survive unharmed indefinitely. As long as a cork is put into the top of the bottle to prevent the effects of evaporation, fruit flies and dust, a vintage Madeira, once opened, can last for decades. Properly sealed in bottles, it is one of the longest-lasting wines; Madeiras have been known to survive over 200 years in excellent condition. It is not uncommon to see 150-year-old Madeiras for sale at stores that specialize in rare wine. Vintages dating back to 1780 are known to exist. The oldest bottle that has come onto the market is a 1715 Terrantez.


title: Madeira wine

text: Before the advent of artificial refrigeration, Madeira wine was particularly prized in areas where it was impractical to construct wine cellars (as in parts of the southern United States) because, unlike many other fine wines, it could survive being stored over hot summers without significant damage. In the Americas, Madeira was traditionally stored in the warm attics of houses.


title: Madeira wine

text: Most Madeira is consumed as wine. Popular uses include apéritifs (pre-meal) and digestifs (post-meal). In Britain it has traditionally been associated with Madeira cake.


title: Madeira wine

text: Because Madeira has a very high acidity, it can be paired with any food, even citrus or balsamic. Also, although it is sweet, even the Malmsey has a dry finish, so it does not get killed by the sweetness of desserts and pudding. This makes it the most versatile of all dessert wines. Whereas most sweet wines are rendered dry by the sweetness of the dessert, this does not happen with Madeira.


title: Madeira wine

text: Madeira is also used as a flavor agent in cooking. Lower-quality Madeira wines may be flavored with salt and pepper to prevent their sale as Madeira wine, and then exported for cooking purposes. Madeira wine is commonly used in tournedos Rossini and "sauce madère" (Madeira sauce). Unflavored Madeira may also be used in cooking, such as the dessert dish "Plum in madeira".


title: Purple Man

text: The Purple Man (Zebediah Kilgrave) is a supervillain appearing in American comic books published by Marvel Comics. Created by writer Stan Lee and artist Joe Orlando, he first appeared in "Daredevil" #4 (October 1964). His body produces pheromones which allow him to verbally control the actions of others, and occasionally break the fourth wall for sinister effect. His stories typically involve him brainwashing other characters. Initially a recurring enemy of Daredevil, he later emerged as the archenemy of Jessica Jones.


title: Purple Man

text: A modified version of the character named Kevin Thompson/Kilgrave was portrayed by David Tennant in the Netflix television series "Jessica Jones" set in the Marvel Cinematic Universe (MCU), for which Tennant received critical praise, and for which the character was included in "Rolling Stone"s list of the "40 Greatest TV Villains of All Time" while IGN ranked him #79 of the "Top 100 Villains".


title: Purple Man

text: Purple Man first appeared in "Daredevil" #4 (November 1964) and was created by writer Stan Lee and artist Joe Orlando.


title: Purple Man

text: Zebediah Kilgrave was born in Rijeka, Croatia. A physician turned international spy, he was sent to infiltrate a chemical refinery and was accidentally doused with a chemical that turned his hair and skin purple. Though he was caught and questioned, offering a weak alibi, he was released. Several more incidents like this demonstrated that the nerve gas had given Kilgrave the ability to command the wills of other people. Calling himself the Purple Man, Kilgrave embarked on a criminal career, where he was largely a Daredevil villain, fighting the Man Without Fear early in his career and being imprisoned in a special cell designed to dampen his powers, until he escaped and moved to San Francisco, building a small criminal enterprise over two years, only for Daredevil to topple it when he and Black Widow moved to the city.


title: Purple Man

text: Early in his criminal career, he used his mind-control powers to force a woman to become his wife. Before she recovered and left him, she became pregnant with his daughter, Kara Kilgrave. Kara inherited his discoloration and powers and became the Alpha Flight-affiliated superhero called the Purple Girl, and later Persuasion in "Alpha Flight" issue #41.


title: Purple Man

text: The character largely disappeared from comic books during the 1980s although he did face Spider-Man, Moon Knight, Daredevil, Power Man, and Iron Fist in "Marvel Team-Up" Annual #4. He also appeared in the graphic novel "Emperor Doom" in which Doctor Doom uses Kilgrave to power a machine called the "psycho-prism" that allowed Doom to control the minds of everyone on Earth. During the process, Purple Man finds out that he cannot control Doctor Doom's mind even at close range, as Doom's mental fortitude is too great.


title: Purple Man

text: He later reappeared in the pages of "X-Men", as the mastermind behind Nate Grey's rise to super-celebrity status as a miracle worker in New York City. He had been subtly manipulating both the population of Manhattan and Nate himself into accepting and embracing the young exile from the "Age of Apocalypse" storyline as a modern messianic figure, who would then become so psychologically empowered by hero worship that he could and would literally change the reality of the world, using the full potential of his mutant power. The plan ultimately failed when Nate learns the truth and loses his confidence, thus reducing his power. Kilgrave goes once more into hiding.


title: Purple Man

text: As detailed in the series "Alias", the Purple Man has since been revealed to be linked to the history of Jessica Jones. When she was the superhero Jewel, he used his mind-control powers to subdue her, forcing her to live with him while psychologically torturing her for several months. He ultimately sends her off to kill Daredevil. The incident with Purple Man leaves her so traumatized that she leaves her life as a superhero behind and becomes a private investigator. Later, the Purple Man escapes again and tries controlling Jessica to kill the Avengers, but she is able to resist and knocks him out. Daredevil later has the Purple Man imprisoned in the Raft, a jail designed for super-powered criminals.


title: Purple Man

text: He escapes briefly when Electro creates a riot at the Raft. Purple Man then attempts to use the opportunity to mind control Luke Cage into killing the then soon-to-be-Avengers and threatens Jones, who is pregnant with Cage's child. Unknown to the Purple Man, drugs had been put into his food to negate his powers during his imprisonment, so he is unable to control Cage, who subsequently beats him to a pulp in response to his demands.


title: Purple Man

text: Later, the Purple Man returned shortly before (and during) the "House of M" storyline and manipulated the Thunderbolts, while being manipulated himself by Baron Zemo, who used the moonstones he had recently acquired to free Kilgrave from prison, leaving an illusion in his place so that the authorities would not be aware of his escape. With his pheromones distributed through the New York City water system and Zemo's moonstones used to project his voice wherever necessary, the Purple Man enslaved the entire city. Under Zemo's direction, he used the city's superhumans as his personal army to attack the Thunderbolts, whom he had worked to turn against each other. Eventually, he was defeated by the Thunderbolts member Genis-Vell, after which Zemo teleported the Purple Man back and tortured him for his failure before sending him back to prison once more.


title: Purple Man

text: During the "Scared Straight" crossover between "Thunderbolts" and "Avengers Academy", the Purple Man is revealed to be incarcerated in the Raft Maximum Security Penitentiary, as Tigra warns her Academy students not to look at his face or read his lips. During a subsequent power outage caused by Academy member Hazmat, the Purple Man, at the head of a small gang of mind-controlled inmates, again crosses paths with a lone Luke Cage, now supervisor of a Thunderbolts team composed of Raft prisoners. Cage makes short work of the Purple Man and his "recruits", revealing that the nanites that maintain control over his Thunderbolts also shield him from Kilgrave's influence.


title: Purple Man

text: During the "Fear Itself" storyline, Purple Man and a majority of inmates are freed after the Raft is severely damaged by the transformation of the Juggernaut into Kuurth: Breaker of Stone and the subsequent damage caused by Kuurth's escape. Before escaping the Raft, the Purple Man attempts to kill a comatose Puppet Master in the prison infirmary, and makes statements indicating that he was behind the Puppet Master's manipulation of Misty Knight's Heroes for Hire organization, using them to establish a criminal organization by proxy while incarcerated. He is prevented from killing the Puppet Master by Heroes for Hire operatives Elektra and the Shroud, but Kilgrave attacks the pair with a mob of mind-controlled inmates driven into a frenzy. When the heroes hold their own against the assault, the Purple Man changes tactics and turns them against each other. He subsequently escapes the Raft via the Hudson River.


title: Purple Man

text: Purple Man later began to form a new criminal empire with the help of Avalanche, Headhunter, Shocker, a new Death-Stalker, and a new Scourge.


title: Purple Man

text: During Daredevil's time in San Francisco after the exposure of his secret identity, he encountered the Purple Man's children, who had inherited their father's powers. After Matt saved the children from a mob and their father, they use a machine their father had created to enhance his powers to boost their own and erase the world's knowledge of Matt's identity as Daredevil.


title: Purple Man

text: Eventually, after tracking down Jessica Jones and taking control of Carol Danvers, Purple Man kills himself by force of will and Captain Marvel throws his body into the sun. They later discover that Danvers was being mind controlled and threw no one into the sun; his son Benjamin, who has similar powers, rescued and revived his body.


title: Purple Man

text: While Kilgrave is killed by Fisk in his crusades on banning superheroes in attempt to expand his criminal empires during "Devil's Reign", the Purple Children are on the run from Fisk to ensure he never forcefully use their mind powers, and eventually being saved by a passing by May Parker.


title: Purple Man

text: The Purple Man's body produces chemical pheromones which, when inhaled or absorbed through the skin, allow Kilgrave to control others' actions as long as he is physically present. These abilities can overwhelm most, but sufficiently strong-willed people, such as Doctor Doom and Kingpin, have been able to resist its influence, and Daredevil has been able to resist Kilgrave as the powers rely on full sensory manipulation, Daredevil's blindness hindering the amount of input he receives and making it easier for him to resist what he picks up. Moon Knight defeated the Purple Man by wearing earplugs that prevented him from hearing the villain's commands; he, Daredevil, and other heroes gagged the Purple Man before giving him to the police to prevent him from commanding others.


title: Something Wicked This Way Comes (novel)

text: Something Wicked This Way Comes is a 1962 dark fantasy novel by Ray Bradbury. It is about two 13-year-old best friends, Jim Nightshade and William Halloway, and their nightmarish experience with a traveling carnival that comes to their Midwestern home, Green Town, Illinois, on October 24th. In dealing with the creepy figures of this carnival, the boys learn how to combat fear. The carnival's leader is the mysterious "Mr. Dark", who seemingly wields the power to grant the townspeople's secret desires. In reality, Dark is a malevolent being who, like the carnival, lives off the life force of those they enslave. Mr. Dark's presence is countered by that of Will's father, Charles Halloway, the janitor of the town library, who harbors his own secret fear of growing older because he feels he is too old to be Will's dad.


title: Something Wicked This Way Comes (novel)

text: The novel combines elements of fantasy and horror, analyzing the conflicting natures of good and evil that exist within all individuals. Unlike many of Bradbury's other novel-length works, such as "Dandelion Wine" and "The Martian Chronicles", which are fix-ups, "Something Wicked This Way Comes" is a single, full-length narrative.


title: Something Wicked This Way Comes (novel)

text: The title is taken from "By the pricking of my thumbs, something wicked this way comes," a line said by the witches in Shakespeare's "Macbeth".


title: Something Wicked This Way Comes (novel)

text: One of the events in Ray Bradbury's childhood that inspired him to become a writer was an encounter with a carnival magician named Mr. Electrico who commanded him to "Live forever!" The 12-year-old Bradbury, intrigued at the concept of eternal life, revisited Mr. Electrico, who spurred his passion for life by heralding him as the reincarnation of a friend lost in World War I. After that memorable day, Bradbury began writing nonstop.


title: Something Wicked This Way Comes (novel)

text: The novel originated in 1955 when Bradbury suggested to his friend Gene Kelly that they collaborate on a movie for Kelly to direct. Kelly was encouraging of the idea, and Bradbury spent the next five weeks adapting his 1948 short story "The Black Ferris" into an 80-page treatment. Kelly shopped the project to various studios, but was unable to obtain financial backing for the movie. Bradbury then gradually expanded the treatment into the novel over a five-year period. He converted the benign presence of Mr. Electrico into a more sinister one and incorporated several members he met at the same carnival with Mr. Electrico, including the Illustrated Man and the Skeleton Man.


title: Something Wicked This Way Comes (novel)

text: The book's autumnal setting was intended as a thematic sequel to Bradbury's summer-tinged" Dandelion Wine". Both works are set in the fictitious Green Town (based on Bradbury's hometown, Waukegan, Illinois) but have different tones, with the seasons in which they are set reflecting different aspects of the transition from childhood to adulthood. While none of the characters in "Dandelion Wine" reappear in "Something Wicked This Way Comes", Will Halloway and Jim Nightshade can be viewed as one-year older representations of "Dandelion Wine"'s Douglas Spaulding and John Huff, respectively. These two novels, coupled with Bradbury's official 2006 sequel to "Dandelion Wine", "Farewell Summer", constitute what Bradbury has termed his "Green Town Trilogy". The 2008 short story collection "Summer Morning, Summer Night" is also set almost entirely in Green Town.


title: Something Wicked This Way Comes (novel)

text: The novel opens on an overcast October 23. Two friends – William "Will" Halloway and Jim Nightshade – both on the verge of their 14th birthdays, encounter a strange lightning rod salesman, Tom Fury. He announces that a storm is coming their way. The salesman gives Jim a lightning rod because he tells the boys that one of their houses is in danger. Throughout the night, Will and Jim meet up with townsfolk who also sense something in the air. Among the townspeople is Will's 54-year-old father, Charles Halloway, who works in the local library. Both Mr. Halloway and the boys learn about the carnival that is to start the next day. Jim and Will are excited that a carnival has come so late in the year, but Charles has a bad feeling about it.


title: Something Wicked This Way Comes (novel)

text: The boys run out to watch the carnival arrive at three in the morning. As the train pulls in, the smoke billows in circles and solidifies as the carnival. The boys go the next day to explore the carnival and encounter their 7th grade teacher, Miss Foley, who is dazed after visiting the Mirror Maze. Jim insists on coming back that night and Will agrees, but when they bump into the lightning-rod salesman's abandoned bag, they realize that they must stay to learn what happens after dark. After investigating all of the rides, they go up to a carousel, which has an out-of-order sign. Mr. Cooger suddenly grabs Will and Jim after they climb up on horses and he informs them the merry-go-round is broken. Mr. Dark arrives and tells him to put them down. He pays attention only to Jim, who is enthralled by what he sees. The boys run away and then hide and wait. Both witness Mr. Cooger riding backwards on the carousel (as the music plays backwards), and when he steps off, to their shock, he is 12 years old.


title: Something Wicked This Way Comes (novel)

text: They follow young Mr. Cooger to Miss Foley's house, where he pretends to be the nephew she was expecting. Jim tries to talk with him, because he wants to ride the carousel, but Will stops him. Jim takes off in the direction of the carnival. When Will catches up, Mr. Cooger is riding the carousel growing older, and Jim is about to join him. Will knocks the switch on the carousel and it flies out of control, spinning rapidly forward. Mr. Cooger ages over 100 years before it stops, and Jim and Will take off. They return with the police, but Mr. Cooger is nowhere to be found. Inside the tents they find him all set up as a new act, "Mr. Electrico", a man they run electricity through. Mr. Dark tells the boys to come back to the carnival the next day. Will tries to keep his father out of the situation, promising him that he will tell all soon. That night, the Dust Witch floats by in her balloon to find Jim and Will. Will lures her to an abandoned house and destroys her balloon with a bow and arrow. They later both dream of a bizarre funeral for the balloon, featuring a giant, misshapen coffin.


title: Something Wicked This Way Comes (novel)

text: The next day the boys find a girl crying on the curb and realize she is the former Miss Foley made young again but also totally blind. They assist her to her house, but when they return they're cut off by a parade. The carnival is out searching the streets for the two of them. The boys hide, and Will's father spots them hiding under a storm drain in front of the cigar store. The boys convince him to keep quiet. Mr. Dark later arrives to talk to him. Mr. Halloway pretends not to know the two boys, whose faces are tattooed on the man's hand, but when the Witch comes and begins to sense the boys' presence, he blows cigar smoke at her, choking her and forcing her to leave. Mr. Dark then asks Charles Halloway for his name, and Will's father tells him he is the town library's janitor. That night Will and Jim meet him at the library where he has done research into his own father's ministerial notes. The carnival arrives once a generation, and leaves in the midst of a giant storm. Mr. Dark appears, and the boys hide in the book stacks. He discovers both of them and crushes the janitor's hand when Mr. Halloway attempts to fight him. The tarot witch casts spells on the boys to mesmerize them and also tries to stop Mr. Halloway's heart. Just before he is about to die, Charles looks at the Witch and begins to laugh hysterically. His laughter wounds her deeply and drives her away. He then follows Mr. Dark to the carnival to rescue the boys.


title: Something Wicked This Way Comes (novel)

text: At the carnival, Charles triumphs over Mr. Dark, finds his son in the mirror maze, kills the Witch with a smile on a bullet, and destroys all the mirrors by using laughter and cheer. Then he and Will search for Jim. Mr. Cooger turns to dust and blows away before he can be saved by the carousel. Jim runs to the merry-go-round and rides it forward. Will tries to stop him and grabs onto his leg. They both end up going for a ride before Will jumps off and rips Jim away from the machine. Jim falls into a stupor, close to death. A child comes begging them to help him, but Mr. Halloway recognizes the boy as Mr. Dark. He holds the boy tight and kills him with affection, because Mr. Dark cannot survive in such close contact with someone so happy. The carnival falls apart as Will tries to revive Jim. They save Jim by singing and dancing and laughing, their happiness bringing him back from the edge of death.


title: Something Wicked This Way Comes (novel)

text: As in "Dandelion Wine", Bradbury infuses the novel with nostalgia for his childhood. However, "Dandelion Wine" embodies the idyllic memories of youth, whereas "Something Wicked This Way Comes" superimposes folk-tale and supernatural elements over a small-town Americana setting in order to explore the dark undercurrents that surround the transition to adulthood.


title: Something Wicked This Way Comes (novel)

text: The novel also conveys the theme that the power of people, objects, and ideas have over you depends on the power you instill in them with your own mind. Because of this, the carnival is able to easily take advantage of the common human fears of aging, death, and loneliness which everyone has or relates to.


title: Something Wicked This Way Comes (novel)

text: Self-centered desires and wishes are portrayed as the base of human malice and unhappiness because they blind people to the blessings of life with an unattainable dream. The novel's main example of this is Miss Foley's seduction by Cooger's promise of youth that causes her to fail to see his deception as her "nephew," and lose her rightful place in society.


title: Something Wicked This Way Comes (novel)

text: It is implied that the counter-force against this is acceptance of one's faults and an enthusiastic pursuit of the everyday joys of life, signified by Charles' spontaneous running with Jim and Will at the end of the novel. The fact that he is nearly forty years older than them pales in comparison to the pleasure he gains from simple human companionship.


title: Something Wicked This Way Comes (novel)

text: Critics have praised "Something Wicked This Way Comes" as a classic of fantasy and horror, noting its masterful blending of both genres and Bradbury's unusual and mesmerizing prose. The most referenced characteristic of the novel's plot is its unusual subtlety and realism for its genres.


title: Something Wicked This Way Comes (novel)

text: "Science Fiction Crowsnest," another science fiction magazine, reviewed it with high praise, referring to it as a "Masterwork" with "a suitably fantastic and scary plot around colourful description ... with hidden meanings, mysteries and symbols adding to the layers of tension."


title: Something Wicked This Way Comes (novel)

text: The "Denver Rocky Mountain News" said in 1999, "If rational beings had created the 100 best books of the century list, this one would surely have been on it."


title: Something Wicked This Way Comes (novel)

text: "Something Wicked This Way Comes" has served as a direct influence on several fantasy and horror authors, including Neil Gaiman and Stephen King. Gaiman paid tribute to Bradbury's influence on him and many of his peers in a 2012 "The Guardian" article following Bradbury's death. King discusses this novel at length in his 1981 non-fiction book "Danse Macabre".


title: Something Wicked This Way Comes (novel)

text: The book also influenced R. L. Stine, who said, "Ray Bradbury is one of my favorite authors. I always tell people that the scariest book I ever read was one of his books—"Something Wicked This Way Comes"."


title: Something Wicked This Way Comes (novel)

text: Stephen King mentions the book in his 1979 novel "The Dead Zone" and echoes the beginning scene of it by referring to a lightning-rod salesman in a chapter titled "Dark Carnival." His novels "'Salem's Lot" (1975), "Needful Things" (1991) and "Fairy Tale" (2022) also contain references from "Something Wicked This Way Comes".


title: Something Wicked This Way Comes (novel)

text: The TV show "South Park" parodied the novel in the 2004 episode "Something Wall-Mart This Way Comes" with a similar plot about the titular department store luring townsfolk with its super-low prices. British TV comedy series "The League of Gentlemen" features the Pandemonium Carnival of Papa Lazarou. In similar vein, the animated TV show "Rick and Morty" paid homage to the novel in an episode titled "Something Ricked This Way Comes", which centers around a comically-shadowy figure granting the citizens of the town wishes, however the plot largely draws upon "Needful Things" by Stephen King. UK Horror soundtrack producer Sam Haynes has released two Halloween themed albums influenced by the novel, "The Incredible Dark Carnival" and "Something Wicked".


title: Something Wicked This Way Comes (novel)

text: The band Creature Feature released a song titled "The Greatest Show Unearthed", which references the novel and takes heavy inspiration for the lyrics.


title: Something Wicked This Way Comes (novel)

text: The band Vernian Process released a song titled "Something Wicked", which shares the novel's setting.


title: Something Wicked This Way Comes (novel)

text: The heavy metal thrash band Nuclear Assault also had the same song title referencing the lyric phrase and their self titled video was also on the same self titled album.


title: Something Wicked This Way Comes (novel)

text: American progressive rock band Stencil Forest released a song called "The Pandemonium Shadow Show" on their debut album "Opening Act", which references the novel and is a straightforward adaptation of the novel.


title: Something Wicked This Way Comes (novel)

text: Hard Rock band Starset released a song also titled "Something Wicked" with parallels to the novel in their song and album's lore, including the novel's title being sang at the end of the song.


title: Something Wicked This Way Comes (novel)

text: "The Night Circus" by Erin Morgenstern features fraternal twins born either side of midnight on opening night of the Cirque de Reves by several minutes. Widget the boy is born first, on the 31st of October. His sister Poppet is born 1st of November. Each possesses bright red hair and a talent for 'seeing' the past (Widget) or the future (Poppet). They are the only circus performers in the plot who age.


title: Something Wicked This Way Comes (novel)

text: American musician Tessa Violet named her 2016 EP "Halloway" after Will Halloway. Violet listened to audiobook version while on tour after her mom said it was "one of the scariest books she’s read, and one of the most well-written."


title: Something Wicked This Way Comes (novel)

text: The novel was made into the 1983 The Bryna Company-Walt Disney Productions film "Something Wicked This Way Comes", with Bradbury as the screenwriter. The production had been in development since the mid-1970s and was originally meant to be financed and distributed by Paramount Pictures. In a later interview, Bradbury said that he considered the film one of the better adaptations of his works.


title: Something Wicked This Way Comes (novel)

text: Bradbury's Pandemonium Theatre Company performed a play based on the novel in Los Angeles on October 1, 2003, directed by Alan Neal Hubbs, also associated with the 1970 stage adaptation of Bradbury's 1950 book "The Martian Chronicles". The main cast was Grady Hutt as Will Halloway, J. Skylar Testa as Jim Nightshade, Jay Gerber as Charles Halloway, and Mark Aaron as Mr. Dark. Critics gave the play generally favorable reviews, stating that it captured the lyricism and dark tone of the novel. They also praised its special effects, which included a carousel constructed of mirrors with actors as the horses, and Jay Gerber as Charles Halloway. Sharon Perlmutter of "Talkin' Broadway", however, said that Hutt and Testa gave bland performances as the two lead characters.


title: Something Wicked This Way Comes (novel)

text: "Something Wicked This Way Comes" was produced as a full-cast radio play by the Colonial Radio Theatre on the Air, and released by Blackstone Audio on October 1, 2007. Ray Bradbury wrote the script, modified for audio from his stage play. The cast includes Jerry Robbins as Mr. Halloway, J.T. Turner as Mr. Dark, Anastas Varinos as Will Halloway, and Matthew Scott Robertson as Jim Nightshade. This production was directed by Nancy Curran Willis, with music by Jeffrey Gage and post-production by Chris Snyder.


title: Something Wicked This Way Comes (novel)

text: Catherine Wheels adapted "Something Wicked This Way Comes" for the stage in coproduction with the National Theatre of Scotland in 2008. The production opened at the Byre Theatre, St Andrews October 27, 2009 and toured the UK.


title: Something Wicked This Way Comes (novel)

text: "Something Wicked This Way Comes" was produced as a radio play for the BBC Radio 4 "Saturday Play" series and was broadcast on 29 October 2011. The production was adapted for radio by Diana Griffiths and produced/directed by Pauline Harris with music by David Paul Jones and sound by Paul Cargill. The cast included Theo Gregory as Will, Josef Lindsay as Jim, Henry Goodman as Charles Halloway, Gerard McDermott as Mr. Cooger/The Lightning Rod Salesman and Kenneth Cranham as Mr. Dark.


title: Bryophyte

text: The Bryophyta s.l. are a proposed taxonomic division containing three groups of non-vascular land plants (embryophytes): the liverworts, hornworts and mosses. Bryophyta s.s. consists of the mosses only. They are characteristically limited in size and prefer moist habitats although they can survive in drier environments. The bryophytes consist of about 20,000 plant species. Bryophytes produce enclosed reproductive structures (gametangia and sporangia), but they do not produce flowers or seeds. They reproduce sexually by spores and asexually by fragmentation or the production of gemmae. Though bryophytes were considered a paraphyletic group in recent years, almost all of the most recent phylogenetic evidence supports the monophyly of this group, as originally classified by Wilhelm Schimper in 1879. The term "bryophyte" comes .


title: Bryophyte

text: The term "Bryophyta" was first suggested by Braun in 1864. G.M. Smith placed this group between Algae and Pteridophyta.


title: Bryophyte

text: Bryophytes exist in a wide variety of habitats. They can be found growing in a range of temperatures (cold arctics and in hot deserts), elevations (sea-level to alpine), and moisture (dry deserts to wet rain forests). Bryophytes can grow where vascularized plants cannot because they do not depend on roots for uptake of nutrients from soil. Bryophytes can survive on rocks and bare soil.


title: Bryophyte

text: Like all land plants (embryophytes), bryophytes have life cycles with alternation of generations. In each cycle, a haploid gametophyte, each of whose cells contains a fixed number of unpaired chromosomes, alternates with a diploid sporophyte, whose cell contain two sets of paired chromosomes. Gametophytes produce haploid sperm and eggs which fuse to form diploid zygotes that grow into sporophytes. Sporophytes produce haploid spores by meiosis, that grow into gametophytes.


title: Bryophyte

text: Bryophytes are gametophyte dominant, meaning that the more prominent, longer-lived plant is the haploid gametophyte. The diploid sporophytes appear only occasionally and remain attached to and nutritionally dependent on the gametophyte. In bryophytes, the sporophytes are always unbranched and produce a single sporangium (spore producing capsule), but each gametophyte can give rise to several sporophytes at once.