The Onlay Folded Flap (OFF) for Nasal Tip Surgery

Mayaleh, Hani Abou

doi:10.1007/978-3-642-28053-5_65

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…1,16,18 Meanwhile, the pronasale area in the tripod structure is improved as a result of the cartilaginous flap crossover fixation, thus functionally intensifying the tip and alar framework. Several types of maneuvers designed to reuse the cephalic portion of the LLC through open approach have been reported [18][19][20] to yield satisfactory outcomes of improvement in tip definition and projection. However, these procedures are not devised for tip supporting structure intensification simultaneously, which is crucial in successful rhinoplasty in Asian patients.…”

Section: Discussionmentioning

confidence: 97%

Broad Tip Modification in Asian Patients Undergoing Rhinoplasty Using the Low-Lateral Cartilage Cruciate Overlap Technique

Yin

Liu

Fan

et al. 2015

JAMA Facial Plast Surg

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IMPORTANCE Asian patients undergoing cosmetic rhinoplasty often want surgeons to concentrate on the broad nasal tip. Modifying the cartilage framework is considered to be the fundamental strategy; during the modification procedures, the cephalic portion of the lower lateral cartilage is often excised and discarded. However, given the supporting function and volumetric filling properties of autologous cartilage, the cephalic cartilage should and can be salvaged by using our cruciate overlap technique.OBJECTIVES To introduce a novel technique in modification of broad nasal tip in Asian patients undergoing rhinoplasty and assess its efficacy and safety. DESIGN, SETTING, AND PARTICIPANTS Dissection of 5 fresh cadaver head specimens was performed and the plausibility and reliability of the new procedure were determined at Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. In addition, the cruciate overlap technique was performed in 43 Chinese patients between January 1, 2011, and December 31, 2013, and the surgical results were assessed subjectively and objectively during the follow-up period, ranging from 12 to 36 months, with the final follow-up November 30, 2014. Anthropometric measurements of patients' noses preoperatively and postoperatively were taken and the patients' complications were reviewed.MAIN OUTCOMES AND MEASURES Cadaveric evaluation, subjective and objective assessments of the surgical results (rated on a scale of 1 to 4, with 4 indicating much improvement from the preoperative level), nasal measurements of the patients, and evaluation of the complications. RESULTSThe mean size of the cartilaginous flap in the cruciate overlap technique was 12.0 mm long and 3.0 mm wide, allowing for 180°rotation and graft coverage, with the nasal cartilage framework protected from collapse. Mean (SD) scores for the subjective and objective judgment of the outcomes were 3.3 (0.4) and 3.5 (0.3), respectively. Moreover, nasal measurements demonstrated significant postoperative improvement by increasing the mean nasal tip protrusion (from 14.3 [1.5] to 16.7 [2.0] mm) and reducing the mean tip width (from 22.7 [1.7] to 18.2 [1.6] mm) and tip angle (from 101.0°[6.3°] to 87.7°[6.7°]) (all P < .001). Acceptable ranges of edema, ecchymosis, and pain were observed in the early postoperative period and resolved within a short period. No aesthetic or functional adverse effects were reported during the follow-up period. CONCLUSIONS AND RELEVANCEThe cruciate overlap technique is an efficacious and reliable alternative for modification of broad nasal tips in Asian patients undergoing rhinoplasty.LEVEL OF EVIDENCE 4.

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Section: Discussionmentioning

confidence: 97%

Broad Tip Modification in Asian Patients Undergoing Rhinoplasty Using the Low-Lateral Cartilage Cruciate Overlap Technique

Yin

Liu

Fan

et al. 2015

JAMA Facial Plast Surg

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“…1 Various methods have been developed to achieve this goal, such as subcutaneous tissue thinning, diverse suturing techniques, various grafts, and trimming the nasal cartilages. [4][5][6][7][8][9][10][11] In the literature, all techniques have limitations and negative aspects. Therefore, these techniques can be combined or modified to obtain an optimal surgical result.…”

mentioning

confidence: 99%

“…Readjustion of nasal definition and projection, providing symmetry and stability of the nasal tip are the primary goals in tip plasty 1 . Various methods have been developed to achieve this goal, such as subcutaneous tissue thinning, diverse suturing techniques, various grafts, and trimming the nasal cartilages 4–11 . In the literature, all techniques have limitations and negative aspects.…”

mentioning

confidence: 99%

The Onlay Rotated Flap (ORF): An Original Technique for Nasal Tip Plasty

Yılmaz¹,

Çakan

Yılmaz

2021

Journal of Craniofacial Surgery

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Objective: The reshaping of the nasal tip in rhinoplasty according to the expectations of the patient and the surgeon is called tip plasty. in this article, the onlay rotated flap (ORF) is presented as a new technique for reshaping, supporting, and projecting the nasal tip without any resection or grafting. Methods: Thirty-two patients (26 female and 6 male) were included in the study retrospectively. Primary rhinoplasty with ORF was performed to all patients. The follow-up period was between 9 and 12months. The nasal tip projection (NTP) with Goode method and nasal tip rotation (NTR) according to nasolabial angle were calculated in standardized preoperative and postoperative(6th month) photographs with image J. SPSS Version 21.0 was used for statistical analysis. Results: There were no complications resulting from our procedure. There were no visible tip flaps, no distortion, no asymmetry, and no alar retraction. Revision surgery was not required in any patient. The preoperative and postoperative means of nasolabial angle (Mean AE SD) were 92.06 AE 7.738 and 99.71 AE 6.068, respectively. The preoperative and postoperative means of NTP (Mean AE SD) were 0.535 AE 0.041 and 0.57 AE 0.386, respectively. The postoperative nasal tip rotation and NTP values of the ORF procedure were found to be statistically significantly higher than the preoperative values (P < 0.05). Conclusions: The ORF technique is another alternative for achieving adequate nasal tip definition and projection and has many advantages and very successful postoperative results. The alar retraction was not encountered in our technique and this is the superior aspect of our technique over similar methods described in the literature.

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The Onlay Folded Flap (OFF) for Nasal Tip Surgery

Cited by 2 publications

References 22 publications

Broad Tip Modification in Asian Patients Undergoing Rhinoplasty Using the Low-Lateral Cartilage Cruciate Overlap Technique

Broad Tip Modification in Asian Patients Undergoing Rhinoplasty Using the Low-Lateral Cartilage Cruciate Overlap Technique

The Onlay Rotated Flap (ORF): An Original Technique for Nasal Tip Plasty

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