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Articles linked to this work by shared authors, journal, and citation graph.

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

Amir Arvin Sazgar1,2, Ali Aalizade3,4, Mohammadhossein Zeyfoalzam3

  • 1Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran. asazgar@sina.tums.ac.ir.

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|April 17, 2026
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Summary

A V-shaped columella-labial incision in reconstructive rhinoplasty significantly improves nasal projection and columellar height compared to mid-columellar incisions. This technique offers better aesthetic outcomes without increased scarring concerns for deformed noses.

Keywords:
External noseNasal surgical proceduresNecrosisReconstructive surgeryRhinoplastySkin

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Facial Reconstruction

Background:

  • Reconstructive rhinoplasty for severely deformed noses demands precise surgical techniques.
  • Mid-columellar incisions are standard, but alternative approaches may yield better results.
  • A prospective study was designed to compare two distinct incision techniques.

Purpose of the Study:

  • To compare the efficacy of a V-shaped columella-labial incision versus a mid-columellar incision in reconstructive rhinoplasty.
  • To evaluate the impact of incision type on nasal projection, columellar height, and scar quality.
  • To determine the optimal surgical approach for improving aesthetic and functional outcomes in complex nasal reconstructions.

Main Methods:

  • A prospective study involving 52 patients undergoing reconstructive rhinoplasty, divided into two groups (n=26 each).
  • Group A utilized a V-shaped columella-labial incision; Group B used a mid-columellar incision.
  • Postoperative outcomes, including nasal projection, columellar height, and scar quality (using the Stony Brook Scar Evaluation Scale), were assessed using standardized photographs one year after surgery.

Main Results:

  • The V-shaped incision group showed statistically significant improvements in nasal projection (adjusted p=0.002) and columellar height gain (p<0.001) compared to the mid-columellar group.
  • Columellar incision type was identified as an independent predictor of projection change.
  • No significant differences in scar quality were observed between the two groups (p=0.557).

Conclusions:

  • The V-shaped columella-labial incision technique leads to superior outcomes in nasal projection and columellar height in reconstructive rhinoplasty.
  • This approach does not compromise scar quality, making it a reliable option for severely compromised nasal structures.
  • Further research is recommended to validate these findings and explore long-term efficacy.