Pitanguy Ligamentous Flap: A New Method to Prevent Supratip Deformity in Rhinoplasty

Area of Science:

• Plastic Surgery
• Rhinologic Surgery
• Aesthetic Surgery

Background:

• Supratip deformity (SD) is a common iatrogenic complication following rhinoplasty.
• Addressing SD remains a significant challenge in nasal tip surgery.

Purpose of the Study:

• To present a novel ligamentous flap technique for creating a precise supratip transition.
• To evaluate the efficacy of this technique in preventing SD and improving nasal tip aesthetics post-rhinoplasty.

Main Methods:

• A ligamentous flap technique was applied to 24 patients undergoing open rhinoplasty.
• Postoperative outcomes, including SD, columellar position, tip projection, and rotation, were assessed.
• Patient and independent surgeon evaluations were conducted at 3 months post-surgery.

Main Results:

• No significant early or late complications (infection, bleeding, prolonged edema) were observed.
• The technique effectively prevented SD, hanging columella, and undesirable changes in tip projection or rotation.
• Patient and surgeon satisfaction scores significantly improved post-operatively, with only minor revisions needed for two patients.

Conclusions:

• The described ligamentous flap technique offers a promising approach for managing nasal supratip aesthetics in open rhinoplasty.
• The technique is adaptable to various skin thicknesses and demonstrates good early functional and aesthetic outcomes.
• Further long-term studies with larger patient cohorts are warranted to fully establish its benefits.