Comparison of Techniques Used to Support the Nasal Tip and Their Long-term Effects on Tip Position

Abstract

Many factors influence the maintenance of tip position in patients who have undergone rhinoplasty. One should consider using a stabilization technique to help resist displacement of the nasal tip. Clinical and operative findings, as well as secondary effects, are used to help determine which technique should be used.

Complications Associated With Alloplastic Implants in Rhinoplasty

“…In these cases, the implant serves as a buttress to support the mass of the nasal tip. 18 The skin and mucosa covering the implant in this region are thin, and their vascularity may be compromised, especially in revision cases. Also, this region of the nose is mobile and subject to repetitive trauma.…”

Estimation of Nasal Tip Support Using Computer-Aided Design and 3-Dimensional Printed Models

“…Some work in this area has been performed. Beaty et al, 10 Dobratz et al, 12 and Wilson et al 11 were able to measure this reaction force to displacement using novel devices. Beaty et al 10 found that 35.54, 61.24, and 89.40 g were required to displace the nasal tip 1, 2, and 3 mm, respectively, along the vector of the columella.…”

“…Beaty et al 10 found that 35.54, 61.24, and 89.40 g were required to displace the nasal tip 1, 2, and 3 mm, respectively, along the vector of the columella. Dobratz et al 12 found that 25 and 50 g were needed to depress the nasal tip approximately 1 and 2 mm, respectively. Wilson et al 11 found that a mean of 1.0 to 3.4 N were needed to compress the nasal tip of a fresh-thawed cadaver from 0.5 to 2.5 mm, respectively.…”

“…Wilson et al 11 found that a mean of 1.0 to 3.4 N were needed to compress the nasal tip of a fresh-thawed cadaver from 0.5 to 2.5 mm, respectively. Our models’ recoil forces were measured in newtons and converted to grams using Earth’s gravitational constant (9.807 m/s 2 ) to enable comparison to the measurements of Beaty et al 10 and Dobratz et al 12 Our series of models required 0.09 to 0.66 N (10–67 g) to be displaced 1 mm, 0.34 to 2.03 N (34–206 g) to be displaced 2 mm, and 0.62 to 3.84 N (62–391 g) to be displaced 3 mm. Using logistic regression, the threshold for the force the nasal tip should support for the absolute minimum requirement for good tip recoil was 0.26 N (27 g), 0.78 N (80 g), and 1.41 N (144 g) at 1, 2, and 3 mm of displacement, respectively.…”

“…Beaty et al, 10 Wilson et al, 11 and Dobratz et al 12 developed tools to measure the reaction force of the nasal tip to displacement before and after rhinoplasty. Gassner et al 13 developed a rhinomanometric device to calculate nasal tip resilience in cadavers.…”