The tension nose: open structure rhinoplasty approach

Area of Science:

• Plastic Surgery
• Rhinology

Background:

• The term
• tension nose
• is recognized by rhinoplastic surgeons, but its definition and management remain unclear.
• This deformity is characterized by excessive quadrilateral cartilage growth, leading to a high nasal dorsum and displaced nasal tip.
• Existing literature offers limited guidance on evaluating and treating tension nose.

Purpose of the Study:

• To define and describe the tension nose deformity.
• To evaluate the prevalence of tension deformity in primary rhinoplasty candidates.
• To present an effective surgical management strategy for tension nose using open structure rhinoplasty techniques.

Main Methods:

• A comprehensive review of surgical literature pertaining to tension nose.
• Analysis of 50 consecutive primary rhinoplasty cases to identify and quantify tension deformity.
• Application of open structure rhinoplasty techniques, focusing on deprojection-reprojection of nasal structures.

Main Results:

• A significant percentage (46%) of primary rhinoplasty candidates exhibited tension deformity requiring surgical correction.
• The study defines tension deformity by excessive quadrilateral cartilage growth, resulting in a high nasal dorsum and anterior/inferior nasal tip displacement.
• Open structure rhinoplasty proved effective in managing tension nose through a deprojection-reprojection process.

Conclusions:

• Tension nose is a prevalent deformity in rhinoplasty, often overlooked in surgical literature.
• Open structure rhinoplasty, utilizing deprojection of the nasal pedestal and reprojection of nasal domes, offers a robust solution.
• This approach enhances nasal tip strength, support, and aesthetic outcomes in patients with tension nose.