Impact of scroll reconstruction on nasal tip rotation and projection following primary open rhinoplasty

Nasal tip stability is a key determinant of long-term rhinoplasty outcomes, yet the role of scroll reconstruction in supporting this stability remains insufficiently studied. This study investigated the impact of scroll reconstruction on nasal tip stability in patients undergoing primary open rhinoplasty with cephalic resection of the lower lateral cartilage. This retrospective study included 69 patients who underwent primary open approach rhinoplasty between 2021 and 2024. The mean age of the patients was 25.18 ± 5.69 years. Standardized lateral photographs were used to assess nasal tip rotation (nasolabial angle) and projection (Goode ratio) preoperatively and at 1 week and 12 months postoperatively. The results revealed that the scroll reconstruction group exhibited significantly less loss of nasal tip rotation (6 degrees) compared with the control group (10 degrees) during long-term follow-up (p < 0.0001). Additionally, the scroll reconstruction group showed significantly less loss of nasal tip projection (0.029) compared with the control group (0.042) during the same period (p = 0.007). Correlation analysis indicated a weak but significant relationship between early postoperative changes and long-term outcomes (r = 0.302, p = 0.012). Our study suggested that scroll reconstruction may contribute to maintaining nasal tip stability by reducing postoperative changes in rotation and projection.