Fine-Tuning of the Supratip in Rhinoplasty: An External Approach.

Area of Science:

• Plastic Surgery
• Otolaryngology
• Facial Plastic Surgery

Background:

• Supratip deformity, or pollybeak deformity, is a common complication of rhinoplasty.
• Revision surgery is often required to correct this iatrogenic issue, especially in patients with thick nasal skin.

Purpose of the Study:

• To introduce and evaluate a novel External Supratip Suture (ESS) technique.
• To prevent supratip deformity and enhance nasal tip definition in rhinoplasty patients, particularly those with thick skin.

Main Methods:

• Eighty-three patients were studied: 33 in a control group (primary rhinoplasty) and 31 in a study group (rhinoplasty with ESS).
• An additional 19 patients with moderate skin also underwent the ESS procedure.
• Supratip aesthetics were evaluated using a tangent line and rated by two blinded plastic surgeons on a 5-point scale.

Main Results:

• The ESS maneuver demonstrated statistically significant improvements (p < 0.05) in supratip aesthetics compared to the control group.
• No ischemic complications were reported following the ESS procedure.

Conclusions:

• The External Supratip Suture (ESS) is a simple, reliable technique for preventing supratip deformity and improving tip definition.
• This method is effective for patients with thick and moderate skin, aiding in nasal volume reduction and skin redraping.
• The ESS technique is a valuable addition to the armamentarium of rhinosurgeons for managing challenging nasal contours.