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Nasal Tip Rotation by Exclusive Superficial Musculoaponeurotic System Deep Medial Ligament Management: An Objective

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Reshaping the nasal tip can be achieved by modifying the superficial musculoaponeurotic system (SMAS) layer. This study found significant nasal tip rotation without affecting projection, solely through SMAS deep medial layer resection.

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Area of Science:

  • Plastic Surgery
  • Facial Anatomy
  • Rhinology

Background:

  • The nasal tip's shape and dynamics are influenced by alar cartilages, skin, and subcutaneous tissue.
  • Nasal tip reshaping considers projection and rotation, achievable via framework or superficial fibromuscular structure (SMAS) modification.

Purpose of the Study:

  • To evaluate nasal tip rotation and projection changes solely by altering the superficial musculoaponeurotic system (SMAS) deep medial layer.
  • To correlate observed nasal tip changes with SMAS structural rearrangements.

Main Methods:

  • Closed rhinoplasty performed on 21 patients (18 female, 3 male) without nasal tip cartilage dissection.
  • Resection of the SMAS deep medial layer was the sole tip modification procedure.
  • Preoperative and postoperative measurements of tip rotation angle, nasolabial angle, and tip projection were recorded.

Main Results:

  • Significant increase in nasal tip rotation was observed post-procedure.
  • No statistically significant decrease in nasal tip projection was found.
  • Changes were attributed to SMAS structural rearrangements.

Conclusions:

  • Nasal tip rotation can be effectively modified by targeting the SMAS deep medial layer.
  • SMAS manipulation offers a method for nasal tip rotation without compromising projection.