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A Prospective Comparison of Inverted V Mid-columellar and V-Shaped Columellar-Labial Incisions in Reconstructive Rhinoplasty.

Aesthetic plastic surgery·2026
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V-Shaped Columella-Labial Incision: A Preferred Incision for Reconstructive Rhinoplasty in Severely Compromised Noses.

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Strategic Use of the V-Shaped Columella-Labial Incision for Reconstructive Rhinoplasty in Severely Compromised Noses.

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    The V-shaped columella-labial incision is safe for reconstructive rhinoplasty, even with prior scars. This technique improves nasal function and aesthetics without increasing complication risks.

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    Area of Science:

    • Plastic Surgery
    • Otolaryngology
    • Rhinoplasty Techniques

    Background:

    • Columellar incision techniques are crucial in reconstructive rhinoplasty for compromised noses.
    • Poor technique can lead to complications like wound dehiscence and skin flap necrosis.

    Purpose of the Study:

    • To evaluate the safety of the columella-labial incision in patients with prior mid-columellar scars.
    • To assess functional and aesthetic outcomes of reconstructive septorhinoplasty using this incision.

    Main Methods:

    • A case series of patients with prior rhinoplasties and mid-columellar scars undergoing open-approach reconstructive septorhinoplasty.
    • Data collected included demographics, surgical history, and operative details.
    • Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) administered pre- and post-operatively.

    Main Results:

    • No dehiscence or vascular complications occurred, even with multiple prior mid-columellar incisions.
    • Significant improvements in nasal obstruction (SCHNOS scores decreased from 52.86 to 18.43) and cosmesis (78.09 to 20.19).
    • Autografts used included auricular cartilage, costal cartilage, temporal fascia, and rectus fascia.

    Conclusions:

    • The V-shaped columella-labial incision is safe and does not elevate vascular compromise risk in patients with mid-columellar scars.
    • This incision facilitates skeletal reconstruction and improves nasal contour and columellar length with acceptable scarring.