Caudal extension graft versus columellar strut with plumping graft for acute nasolabial angle correction in rhinoplasty surgery

2014 ◽  
Vol 272 (7) ◽  
pp. 1673-1677 ◽  
Author(s):  
S. Atighechi ◽  
B. S. Sajadinejad ◽  
M. H. Baradaranfar ◽  
M. H. Dadgarnia ◽  
H. Shahbazian
Keyword(s):  
Columellar Strut ◽  
Nasolabial Angle ◽  
Angle Correction ◽  
Extension Graft

The Caudal Septum Pivot Technique for Short Nose Correction

2021 ◽  
Author(s):  
Tito M. Marianetti ◽  
Valentino Vellone ◽  
Francesca De Angelis ◽  
Valerio Ramieri
Keyword(s):  
Simple Method ◽  
Short Nose ◽  
Tip Projection ◽  
Septal Extension Graft ◽  
Nasolabial Angle ◽  
Revision Rhinoplasty ◽  
Anterior Nasal Spine ◽  
Caudal Portion ◽  
Extension Graft ◽  
Nasal Length

AbstractThe short nose represents one of the greatest challenges in rhinoplasty. It is characterized by a reduced distance from the nasal radix to the tip-defining points, often associated with inadequate tip projection. Several techniques have been described for correction of short nose with the common objective of replacing and rebuilding the osteocartilaginous framework. One of the most effective method to correct the short nose is the septal extension graft. The authors describe the caudal septum pivot (CSP) technique, a simple method to elongate short noses by using a graft inserted in the dorsal septum after its division using as pivot the caudal portion, without detaching it from its natural anchorage to the anterior nasal spine. A retrospective analysis was performed reviewing the clinical charts and the operative records of 315 patients who underwent revision rhinoplasty from January 2015 to June 2019; among this group, 34 were considered eligible for the study. The patients (8 men, 26 women; mean age: 25.4 years; age range: 22–53 years) were divided into two groups: in 12 patients (Group 1) the CSP technique was performed, while Group 2 was composed of 22 patients who received a more classic treatment with a septal extension graft. To evaluate the outcomes, nasal length, tip projection, and tip rotation were measured pre- and 1 year postoperatively on digital photographs of each patient. Nasal anthropometric measurements revealed, at 12-month visit follow-up, an improvement in nasal length, tip projection, and nasolabial angle was achieved in all the patients. The comparison of the pre- and postoperative values showed a statistically significant reduction in the nasolabial angle (p < 0.05) and an increase in the tip projection (p < 0.05) and in the nasal lengthening (p < 0.05) in both groups. In authors' experience, the CSP technique could be considered a safe, reliable, and effective alternative technique in selected patients.

Assessment of Columellar Widening with Columellar Strut Placement

FACE ◽  
2021 ◽  
pp. 273250162110220
Author(s):  
Julia Toman ◽  
Liliya Benchetrit ◽  
Annika Meyer ◽  
James Zachary Porterfield ◽  
Jonathan Y. Lee ◽  
...  
Keyword(s):  
Mount Sinai Hospital ◽  
Nasal Tip ◽  
Columellar Strut ◽  
Primary Rhinoplasty ◽  
Significant Difference ◽  
Tongue In Groove ◽  
The Mean ◽  
Open Versus ◽  
Extension Graft

Objective: The columellar strut is a frequently used technique to provide nasal tip support and projection that is commonly thought to increase columellar width. However, systematic review of the effect has not been reported in the literature. We report a quantitative evaluation of the effect of columellar strut placement on columellar width. Methods: A retrospective cohort study of changes in columellar width in base view photographs for patients who underwent primary rhinoplasty with columellar strut placement (n = 35) and the closely related septal extension graft (n = 9) and tongue-in-groove (n = 5) procedures at Mount Sinai Hospital between 2010 and 2017. The ratio of the columellar width to the intercanthal distance was used to standardize the results among patients. Comparisons were made at follow-up periods of <1 week, 2 to 4 weeks, 1 to 3 months, 3 to 6 months, 6 to 12 months, and >1 year of follow-up. Results: Forty-nine patients (41% female; average age of 43 ± 15 years) were reviewed. The columellar width showed a statistically significant increase for all follow-up date ranges with the exception of 1 week and 3 to 6 months post-operatively. At >1 year of post-operative follow-up, the mean increase in columellar width was 8.6% (95% CI, 2.6%-14.5%, P = .0098). No statistically significant differences were noted between open versus closed procedure for all followup visits after the 1 week followup, and no significant difference if a septocolumellar stitch was placed. Conclusions: A columellar strut was demonstrated to lead to an increase in columellar width. Though the effect was modest at a 8.6% increase, this is a potential cosmetic consideration for the surgeon employing its use to provide nasal tip support and projection.

scholarly journals Comparative Analysis and Long-Term Results of Various Septal Extension Graft Types

2020 ◽  
Vol 36 (03) ◽  
pp. 263-267
Author(s):  
M. Brandstetter ◽  
M. Bhatt ◽  
M. Pham ◽  
W. Gubisch ◽  
S. Haack
Keyword(s):  
Long Term Results ◽  
Digital Measurement ◽  
Tip Projection ◽  
Nasolabial Angle ◽  
Significant Difference ◽  
Different Types ◽  
Extension Graft ◽  
Nasal Length

AbstractShape, tip projection, and position can be controlled by the use of septal extension grafts (SEG). A retrospective cohort study of patients undergoing primary and secondary rhinoplasty was reviewed. The purpose of this study was to analyze maintenance of nasal length, dorsal length, and nasolabial angle postoperatively comparing different types of SEG using standardized photography and digital measurement. Two-hundred twenty-one patients undergoing rhinoplasty were included. There was a statistically significant change regarding the nasolabial angle during the time of follow-up decreasing from 97.53 to 95.30 degrees. No changes could be found in dorsal and nasal length. There was no significant difference among the techniques used to fixate the SEG. The nasolabial angle appeared to decrease from the position 2 weeks postoperatively without changes in the dorsal and nasal length. This means that the decrease in the nasolabial angle depends on the swelling effect and not on drooping of the tip confirming the reliability of SEG over time.

scholarly journals New Technique in Nasal Tip Plasty: Sandwich Technique Using Cartilage and Septal Bone Complex

2019 ◽  
Vol 99 (9) ◽  
pp. 599-604 ◽  
Author(s):  
Tae Hwan Ahn ◽  
Tao Zheng ◽  
Hee Jeong Kang ◽  
Byung Joon Yoo ◽  
Jae Ho Chung ◽  
...  
Keyword(s):  
Septal Cartilage ◽  
P Value ◽  
Ethmoid Bone ◽  
Sandwich Technique ◽  
Nasal Tip ◽  
Tip Projection ◽  
Septal Extension Graft ◽  
Nasolabial Angle ◽  
Nasal Tip Plasty ◽  
Extension Graft

Objectives: It is extremely difficult to obtain ideal tip projection and nose lengthening by septal extension graft using only septal cartilage in Asians, because their nasal septal and alar cartilages are small and weak. Therefore, we introduce a new septal extension graft using a cartilage–bone complex with the vomer and the perpendicular plate of the ethmoid bone as well as cartilage to obtain optimal outcomes. Methods: Participants included 30 patients who underwent surgery by external approach. The septal cartilage, vomer, and perpendicular plate of the ethmoid bone harvested by septoplasty were used. There were 2 layers of cartilage on each side and bone in between to create a strong cartilage–bone complex for projection and lengthening. The bony portion was placed in the tip side, and the double-layered cartilage portion was placed in the inferior portion of the caudal septum of the L-strut to create powerful fixation. Results: There were statistically significant improvements in nasal length (4.71 ± 0.65 vs 5.15 ± 0.53 cm, P value <.0001), tip projection (2.66 ± 0.40 vs 3.18 ± 0.42, P value <.0001), and nasolabial angle (94.0° ± 9.3° vs 107.2° ± 9.6°, P value <.0001) postoperatively. All patients were subjectively satisfied, and 2 different surgeons had excellent or good opinions in 28 (94%) patients. Conclusions: The sandwich technique using cartilage and bone complex results in satisfactory outcomes with stronger tip support, especially in Asians with a weak nasal tip who desire ideal tip projection and dramatic change.

scholarly journals Nasal Tip Drop After Rhinoplasty Resulting from The Excessive Use of Masks: A New Complication in The Covid-19 Pandemic?

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Merkle A
Keyword(s):  
Nasal Tip ◽  
Septal Extension Graft ◽  
Columellar Strut ◽  
Tongue In Groove ◽  
Extension Graft

Postoperative dropping of the nasal tip after rhinoplasty is a known complication. Defining the position of the nasal tip begins with stabilizing the nasal base. To define the position of the nasal tip and stabilize the nasal base of the nose, the surgeon has three main options: tongue-in-groove maneuver, caudal septal extension graft, or columellar strut.

scholarly journals Conservative treatment of a Class I malocclusion with 12 mm overjet, overbite and severe mandibular crowding

2012 ◽  
Vol 17 (5) ◽  
pp. 43-52
Author(s):  
Marcos Alan Vieira Bittencourt ◽  
Arthur Costa Rodrigues Farias ◽  
Marcelo de Castellucci e Barbosa
Keyword(s):  
Class I ◽  
Facial Features ◽  
Conservative Approach ◽  
Upper Lip ◽  
Facial Aesthetics ◽  
Lower Lip ◽  
Angle Class ◽  
Nasolabial Angle ◽  
Lower Arch ◽  
Lower Incisors

INTRODUCTION: A female patient aged 12 years and 2 months had molars and canines in Class II relationship, severe overjet (12 mm), deep overbite (100%), excessive retroclination and extrusion of the lower incisors, upper incisor proclination, with mild midline diastema. Both dental arches appeared constricted and a lower arch discrepancy of less than -6.5 mm. Facially, she had a significant upper incisors display at rest, interposition and eversion of the lower lip, acute nasolabial angle and convex profile. OBJECTIVE: To report a clinical case consisting of Angle Class I malocclusion with deep overbite and overjet in addition to severe crowding treated with a conservative approach. METHODS: Treatment consisted of slight retraction of the upper incisors and intrusion and protrusion of the lower incisors until all crowding was eliminated. RESULTS: Adequate overbite and overjet were achieved while maintaining the Angle Class I canine and molar relationships and coincident midlines. The facial features were improved, with the emergence of a slightly convex profile and lip competence, achieved through a slight retraction of the upper lip and protrusion of the lower lip, while improving the nasolabial and mentolabial sulcus. CONCLUSIONS: This conservative approach with no extractions proved effective and resulted in a significant improvement of the occlusal relationship as well as in the patient's dental and facial aesthetics.

Sign in / Sign up

Export Citation Format

Share Document