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Quantitative Assessment Protocol for Facial Soft Tissue Volumetric Changes with Stereophotogrammetry
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Quantifying Changes in Nasal Tip Support.

Thomas J Willson1, Tyler Swiss2, Jose E Barrera3

  • 1Department of Otolaryngology-Head and Neck Surgery, San Antonio Military Medical Center, San Antonio, Texas.

JAMA Facial Plastic Surgery
|September 18, 2015
PubMed
Summary

This study quantifies nasal tip support changes after rhinoplasty maneuvers in cadavers. Caudal extension grafts significantly increased tip support, while other maneuvers had minimal impact.

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Area of Science:

  • Plastic Surgery
  • Anatomy
  • Biomechanical Testing

Background:

  • Nasal tip modification is a complex aspect of rhinoplasty.
  • Accurate preoperative assessment and precise surgical execution are crucial for desired outcomes.

Purpose of the Study:

  • To evaluate nasal tip resistance to compression before and after specific rhinoplasty techniques.
  • To utilize a novel method for assessing tip support in a cadaveric model.

Main Methods:

  • Open rhinoplasty maneuvers were performed on 6 fresh-thawed cadaver heads.
  • A motorized, computer-controlled test stand with a digital load cell measured tip support.
  • Compression to 2.5 mm was applied, recording force data in Newtons (N).

Main Results:

  • Septoplasty with skin-soft-tissue envelope elevation showed no significant change in tip support (1.82 N vs. 1.60 N).
  • Caudal extension grafts significantly increased nasal tip support by over 66% (3.16 N; P < .01).
  • Columellar struts did not significantly enhance tip support (1.28 N), and intradomal sutures slightly decreased it (1.22 N; P < .01).

Conclusions:

  • Materials testing equipment can effectively quantify changes in nasal tip support after rhinoplasty maneuvers.
  • Minor maneuvers relying on scar formation do not significantly alter tip support in cadavers.
  • Caudal extension grafts are a key maneuver for significantly enhancing nasal tip support.