scholarly journals The Horn Technique for Nasal Tip Support in Rhinoplasty

Author(s):  
Luiz Carlos de Melo Barboza ◽  
Maíra Garcia Martins ◽  
Carlos Alberto Caropreso ◽  
José Luiz Teixeira Rodrigues ◽  
André Baraldo Rodrigues

Abstract Introduction The predictability of nasal tip projection and rotation after aesthetic surgery is a challenge. Tongue-in-groove (TIG) is an effective technique to control tip projection and rotation, but there may be a small loss of projection and rotation of the tip lobe due to lack of support between the anterior septal angle and the domus, since this region is sustained by medial crusts suture-linked and interdomus sutures. Objective To describe a new surgery technique in an attempt to correct the lack of support for the nasal tip after lowering the nasal dorsum. Methods The horn technique consists in preserving a square of cartilage during the removal of the nasal dorsum and septum excess in patients with long and projected nose. This piece will give greater support to the TIG technique and greater predictability of the rotation and projection of the nasal tip. Results Between 2016 and 2018, 50 patients with long and projected noses were submitted to the “horn technique” surgery. They were submitted to the TIG technique associated to the horn technique. A retrospective review of the preoperative and postoperative photographs (3 months to 1 year) of these patients treated with the horn technique were analyzed and showed better support of the nasal tip. Conclusion The horn technique provides greater support to the projection and rotation of rhinoplasties in patients with long and projected nose.

Author(s):  
Fatemeh Khabir ◽  
Mehdi Sezavar ◽  
Behnam Bohluli ◽  
Vahid Mesgarzadeh ◽  
Hamidreza Tavakoli

Author(s):  
Sik Namgoong ◽  
Soobyn Kim ◽  
Hyung-Rok Kim ◽  
Seong-Ho Jeong ◽  
Seung-Kyu Han ◽  
...  

Abstract Background Septal extension grafting (SEG) is used for nasal tip projection and positioning. Often, insufficient quadrangular cartilage is available for grafting in Asians and in most secondary cases, the septum is already harvested. We utilized the folded cymba concha as an alternative for caudal SEG (CSEG) by modifying a tongue-in-groove technique. Objectives To evaluate the physical validity of the cymba concha for CSEG and compare its outcomes with those of septal quadrangular cartilage. Methods The mean length and width of 311 harvested consecutive folded cymba conchae were measured from intraoperative photographs. Data from 220 patients with >12 months of follow-up were retrospectively reviewed for clinical outcomes. Clinical demography was determined based on the need for additional spreader grafts. For clinical reliability, anthropometric photographs of patients in whom folded cymba conchae were used were compared with those in whom quadrangular cartilage was used. Results Mean lengths and widths of the folded cymba conchae in men and women were 24.2 ± 3.9 and 22.4 ± 3.7 mm, and 7.8 ± 1.9 and 7.2 ± 1.9 mm, respectively. Using the folded cymba concha graft significantly increased nasal tip projection by 28.9% and columellar-labial angle by 9.7%, improving both aspects postoperatively. Anthropometric comparison revealed no significant differences between folded cymba conchae and septal cartilage in terms of nasal tip projection (p = 0.264) and postoperative columellar-labial angle (p = 0.182). Conclusions Folded cymba conchal cartilage can be a primary option for CSEG in Asian septorhinoplasty cases or for individuals with insufficient septal cartilage remnants.


1999 ◽  
Vol 1 (4) ◽  
pp. 312-315 ◽  
Author(s):  
Jennifer Parker Porter ◽  
M. Eugene Tardy ◽  
Jacqueline Cheng

2020 ◽  
Vol 277 (5) ◽  
pp. 1371-1377 ◽  
Author(s):  
S. Bucher ◽  
S. Kunz ◽  
M. Deggeller ◽  
D. Holzmann ◽  
M. B. Soyka

2019 ◽  
Vol 40 (5) ◽  
pp. 560-567 ◽  
Author(s):  
Thuy-Van T Ho ◽  
Eric W Cerrati ◽  
Nimit D Gandhi ◽  
Arjun Kalbag ◽  
Steven H Dayan

Abstract Background This is the first study to evaluate the effect of premaxillary filler injection on nasal tip projection, upper lip projection, and upper lip vermilion height. Objectives The primary objective of this study was to analyze the change in nasal tip projection (measured by the Goode ratio) and the change in upper lip projection (measured by the Z angle) following premaxillary hyaluronic acid injection. A secondary objective was to measure the change in upper lip vermilion height. We hypothesized that treated subjects will show an increase in nasal tip projection, upper lip projection, and upper lip vermilion height. Methods Twenty volunteer patients with signs of perioral aging or poor upper lip projection were enrolled in this prospective cohort study and underwent premaxillary hyaluronic acid filler injection between November 2017 and June 2018. Nasal tip projection, upper lip projection, and upper lip vermilion height were assessed from baseline and posttreatment photographs based on the Goode ratio, Z angle, and lip vermilion height ratio, respectively. Results No significant change was noted between pre- and posttreatment Goode ratio measurements (P = 0.841). There was a significant decrease in Z angle and therefore significant increase in upper lip projection with treatment (P < 0.001). The lip vermilion height ratio demonstrated a trend of increased upper lip vermilion height but this did not achieve statistical significance (P = 0.561). Conclusions Premaxillary filler treatment resulted in a significant increase in upper lip projection. Premaxillary filler injection when performed in a safe manner is a valuable treatment option for perioral rejuvenation. Level of Evidence: 4


1988 ◽  
Vol 98 (2) ◽  
pp. 202???208 ◽  
Author(s):  
ROGER L. CRUMLEY ◽  
MICHAEL LANSER

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