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Nasal tip projection. Quantitative changes following rhinoplasty
M A Petroff1, E G McCollough, D Hom
1Department of Otolaryngology, Oregon Health Sciences University, Portland.
Archives of Otolaryngology--Head & Neck Surgery
|July 1, 1991
Summary
Nasal tip projection decreases after rhinoplasty unless specific techniques strengthen the medial crura. Key factors include medial crura, septal attachment, and cartilage grafts for stable results.
Area of Science:
- Plastic Surgery
- Facial Plastic Surgery
- Otolaryngology
Background:
- Nasal tip projection is a critical aesthetic and functional component of rhinoplasty.
- Understanding the anatomical factors influencing postsurgical nasal tip projection is essential for achieving patient goals.
Purpose of the Study:
- To evaluate changes in nasal tip projection following primary rhinoplasty.
- To identify key anatomical components and surgical techniques that influence nasal tip projection outcomes.
Main Methods:
- Prospective study involving 51 patients undergoing primary rhinoplasty.
- Serial measurements of nasal tip projection preoperatively, intraoperatively, and 6 months postoperatively.
- Correlation of projection changes with specific surgical procedures and anatomical findings.
Main Results:
- Medial crura, their septal attachment, and cartilage grafts are vital for postsurgical nasal tip projection.
- Nasal tip projection typically decreases postoperatively without specific measures to enhance medial crural length/strength.
- Techniques like the McCollough-modified Goldman tip procedure, cartilage struts, and plumping grafts can increase projection.
- The double-dome unit procedure refines lobule width but doesn't permanently increase projection.
- Conservative procedures (e.g., complete strip) may decrease projection, suitable for intended retrodisplacement.
Conclusions:
- Surgical techniques must actively address medial crural support to maintain or increase nasal tip projection.
- Careful consideration of preoperative goals and procedural effects on nasal tip anatomy is crucial for successful rhinoplasty.
- Specific grafts and modifications are necessary to achieve stable and predictable nasal tip projection outcomes.