Tip Droop Prevention in Rhinoplasty: Dynamic Effect of Strut Graft on Smiling versus Depressor Muscle Release

Area of Science:

• Plastic Surgery
• Facial Aesthetics
• Rhinoplasty Techniques

Background:

• Aesthetic rhinoplasty presents surgical challenges, with nasal tip droop during smiling being a common patient concern.
• The depressor septi nasi muscle's role in dynamic nasal tip changes requires investigation.
• Understanding muscle function is crucial for optimizing aesthetic surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy of depressor septi nasi muscle release, with or without a columellar strut graft, in reducing nasal tip droop during smiling.
• To provide measurable data on the impact of these surgical modifications on the nasolabial angle.
• To assess the contribution of columellar strut grafting to dynamic nasal tip stability.

Main Methods:

• Retrospective review of endonasal rhinoplasty cases (2015-2019) by a single surgeon.
• Analysis of lateral smiling photographs to measure changes in the nasolabial angle.
• Comparison of two surgical groups: depressor septi nasi muscle release alone versus muscle release combined with a columellar strut graft.

Main Results:

• Patients undergoing muscle release alone showed a mean nasolabial angle increase of 3.66 degrees upon smiling.
• Patients receiving muscle release with a columellar strut graft exhibited a mean nasolabial angle increase of 2.27 degrees.
• The combination of columellar strut grafting and muscle release resulted in a measurable reduction in tip droop.

Conclusions:

• Columellar strut grafting combined with depressor septi nasi muscle release is more effective in alleviating nasal tip droop during smiling than muscle division alone.
• The columellar strut graft enhances nasal tip stability, improving dynamic aesthetic results after rhinoplasty.
• This combined approach offers a valuable strategy for optimizing functional and aesthetic outcomes in rhinoplasty.