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Revision Rhinoplasty in Retrocolumellar Perforation
Sercan Göde1, Aynur Aliyeva2,3, Mehmet Burak Apaydın4
1Otorhinolaryngology Department, Özel Sağlık Hospital, Ege University School of Medicine, Izmir, Turkey.
Aesthetic Plastic Surgery
|May 4, 2026
Summary
Repair of retrocolumellar perforations (RCPs) using vascularized flaps achieved high closure rates and improved nasal tip support. This method significantly enhanced patient-reported outcomes in complex revision rhinoplasty cases.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Rhinoplasty
Background:
- Retrocolumellar perforations (RCPs) are rare but significant complications following revision rhinoplasty.
- These defects often lead to columellar retraction, shortened nasal length, and diminished tip projection.
- Repair necessitates vascularized flaps for mucosal coverage and structural integrity.
Purpose of the Study:
- To assess the efficacy of endonasal and gingivobuccal flaps in repairing RCPs.
- To evaluate outcomes regarding perforation closure, nasal tip projection, and patient satisfaction.
- To analyze the impact of these repairs on cosmetic and functional nasal aspects.
Main Methods:
- A cohort of 28 patients with RCPs underwent surgical repair.
- Flap selection was based on intraoperative findings; all cases utilized rib cartilage grafts.
- Outcomes were measured by perforation status, nasal tip projection, and the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS).
Main Results:
- Successful perforation closure was achieved in 96.4% of patients (27/28).
- Nasal tip projection was maintained in 82.1% of patients (23/28).
- SCHNOS scores showed significant improvement, rising from 18.2 preoperatively to 89.4 postoperatively (p < 0.001).
Conclusions:
- Structured vascularized flaps offer high success rates for RCP repair, ensuring reliable nasal tip support.
- Significant functional and cosmetic improvements are achievable with these reconstructive techniques.
- Gingivobuccal flaps are particularly beneficial for revision cases with compromised anterior nasal structures.
