The Quantification of Surgical Changes in Nasal Tip Support

Beaty, Mark M.; Dyer, Wallace K.; Shawl, Matthew W.

doi:10.1001/archfaci.4.2.82

Cited by 64 publications

(63 citation statements)

References 8 publications

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“…They increase tip support by as much as 40 percent. 2 This aids in resisting skin envelope compressive forces and wound healing contractile forces. Increased medial crural support contributes to establishing and maintaining the desired degree of tip projection and rotation.…”

Section: Discussionmentioning

confidence: 99%

The Caudal Septum Columellar Strut Graft

Hidalgo

Doft

2015

Plastic and Reconstructive Surgery

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Section: Discussionmentioning

confidence: 99%

The Caudal Septum Columellar Strut Graft

Hidalgo

Doft

2015

Plastic and Reconstructive Surgery

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“…Beatty and associates examined tip support with various maneuvers in rhinoplasty. 5 The found that division of the ligamentous attachments between the lower lateral cartilages resulted in 25% loss of tip support. Recontouring of these fibers increased tip support by 33%, and the addition of a columellar strut further increased support by 44% from preoperative levels.…”

Section: Base Stabilization and Control Of Projectionmentioning

confidence: 99%

“…The graft is typically made from the conchal bowl area and fashioned in a strip (Figs. [3][4][5]. Although this graft will assist opening the internal nasal valve, it does so occasionally at the cost of aesthetic consequences.…”

Section: Addressing Internal Nasal Valve and Middle Vault Deficienciesmentioning

confidence: 99%

Structural Approach to Endonasal Rhinoplasty

Shah

Miller²

2006

Facial plast Surg

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The marriage of endonasal rhinoplasty with structural grafting has resulted in more consistent rhinoplasty results. The nasal base can be stabilized by tongue-in-groove techniques, a columellar strut, or extended columellar strut. The middle vault can be addressed with spreader grafts or butterfly grafts. Lower lateral cartilage weakness can be supported with alar batten grafts or repositioning of the lower lateral cartilages.

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“…Various manipulations have to be made on the nasal tip especially when the patient has bulbous nose [4]. Lately many types of surgical methods have been described to get the desired post-operative outcome [5,6]. However, in no studies so far has an objective classification been made of the nasal tip by neither the use of a diagnostic test, nor the necessity of an intervention in the nasal tip has been described.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonography for Rhinoplasty

Copçu¹

2005

CMIR

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Objective: To get the desired outcome and minimize the complications in rhinoplasty it is essential that the anatomy of the nose be precisely known and an appropriate surgical technique should be chosen for the existing problem in a given patient. Preoperative assessment in rhinoplasty is usually based on a physical examination and photographs of the patient. To date, there has been no objective diagnostic test for nose anomalies such as bulbous nasal tip.Methods: In this study we measured the interdomal distance and size of the interdomal fat pad using USG in a total of 40 rhinoplasty patients. Open rhinoplasty was performed in all patients. Also, interdomal fat pad was dissected and excised in all patients. The size of the specimens was determined and their histopathological diagnoses were made. All the cases were evaluated in the 6th month after the operations. Reviewing of the literature was performed.Results: Before the operation, six patients had been diagnosed as bulbous nasal tip clinically. In the patients with bulbous nose both interdomal distance and interdomal fat pad proportions were found to be larger than normal. In the cases in which tip refinement had been performed the interdomal distance was measured as zero.Conclusions: Joseph in 1931 used the "profilometer"; Webster et al. in 1977 used the projectometer in the evaluation of the nose. The evaluation of the anatomical structure of the nose has been the topic of many anthropometric studies and advanced and highly detailed studies with 3 dimensional facial plaster models; digitizer or laser surface scanners have appeared the literature. Tasman and Helbig used the ultrasonography in the evaluation of the nasal tip area. Evaluation of the interdomal space by using USG is quite simple, cheap and easily applicable. In addition, interdomal fat pad can be visualized and an objective criterion can be obtained for bulbous nose by measuring the interdomal distance on USG. Since the excision of interdomal fat pad could only be achieved by open rhinoplasty, and that tip refinement is required in order to correct the increased interdomal distance, pre-operative interdomal USG will guide the surgeon and provide objective criteria in determination of the operative technique in bulbous nose. This is the first study to show interdomal fat pad by a diagnostic test and it can be concluded that interdomal fat pad excision is necessary for the prevention of supratip.

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The Quantification of Surgical Changes in Nasal Tip Support

Abstract: To quantify the changes in the strength of nasal tip support associated with various surgical modifications and to identify the procedures that best maintain or augment tip support.

Cited by 64 publications

References 8 publications

The Caudal Septum Columellar Strut Graft

The Caudal Septum Columellar Strut Graft

Structural Approach to Endonasal Rhinoplasty

Ultrasonography for Rhinoplasty

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