Reply: Control of Nasal Tip Position: Quantitative Assessment of Columellar Strut versus Caudal Septal Extension Graft

2020 ◽  
Vol 146 (3) ◽  
pp. 362e-363e
Author(s):  
Derek M. Steinbacher
Keyword(s):  
Quantitative Assessment ◽  
Nasal Tip ◽  
Septal Extension Graft ◽  
Columellar Strut ◽  
Tip Position ◽  
Extension Graft

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.

A Simplified Use of Septal Extension Graft to Control Nasal Tip Location

2007 ◽  
Vol 31 (5) ◽  
pp. 506-511 ◽  
Author(s):  
Ahmet Seyhan ◽  
Sema Ozden ◽  
Ummahan Ozaslan ◽  
Emin Sir
Keyword(s):  
Nasal Tip ◽  
Septal Extension Graft ◽  
Extension Graft

Correction of the nasal tip and columella in Koreans by a complete septal extension graft using an extensive harvesting technique

2007 ◽  
Vol 60 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Jun Sik Kim ◽  
Ki Hwan Han ◽  
Tae Hyun Choi ◽  
Nam Gyun Kim ◽  
Kyung Suk Lee ◽  
...  
Keyword(s):  
Nasal Tip ◽  
Septal Extension Graft ◽  
Harvesting Technique ◽  
Extension Graft

Nasal Tip Surgery in Asians

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P31-P31
Author(s):  
Tae-Bin Won ◽  
Hong-Ryul Jin ◽  
Hyeon-Jong Lee
Keyword(s):  
Surgical Techniques ◽  
Tertiary Hospital ◽  
Initial Diagnosis ◽  
Saddle Nose ◽  
Nasal Tip ◽  
Tip Projection ◽  
Septal Extension Graft ◽  
Low Profile ◽  
Extension Graft ◽  
Onlay Grafts

Objective The authors intended to review our surgical techniques used in Asian tip surgery and to suggest effective techniques, according to the types of the nasal tip that are addressed. Methods 107 patients who had nasal tip surgery from Jan. 2005 to Dec. 2006 in a tertiary hospital were enrolled in the study. Medical records, graphic operation records, and standardized patient photographs were retrospectively reviewed. Initial diagnosis, types of nasal tip surgery, associated operative techniques, surgical results and complications were analyzed. Results Initial diagnosis included deviated nose, hump nose, combine deviated and saddle nose, low profile nose, short nose, and cleft nose deformity, in order of frequency. Nasal tip surgery included augmentation of projection, control of rotation, restoration of symmetry and volume reduction, among which augmentation was used in all cases. External approach was used in 74% and intranasal approach in 26%. For augmentation of the tip projection, onlay grafts (39%), septal extension grafts (25%), and tip modifying suture with onlay grafts (20%) were the most commonly used methods. Infection or extrusion of the grafts was not found. Complications included tip deviation due to the deviation of the septal extension graft in 1 case, visible tip graft in 1 case, and slight upward rotation of the tip in 1 case. Conclusions In Asians, augmentation of the tip projection is the main issue in tip surgery and is best performed with cartilage onlay grafts or septal extension graft rather than suture modification.

Centering a Deviated Nose by Caudal Septal Extension Graft and Unilaterally Extended Spreader Grafts

2019 ◽  
Vol 129 (5) ◽  
pp. 448-455 ◽  
Author(s):  
Yung Yuan Chen ◽  
Shin Ae Kim ◽  
Yong Ju Jang
Keyword(s):  
Postoperative Complications ◽  
Anthropometric Measurements ◽  
Study Patient ◽  
Open Rhinoplasty ◽  
Nasal Tip ◽  
Tip Projection ◽  
Deviated Nose ◽  
Septal Extension Graft ◽  
Nasal Tip Projection ◽  
Extension Graft

Objective: The deviated nose presents a tremendous challenge for rhinoplasty surgeons, especially the correction of the cartilaginous dorsum deviation. In this study, we introduce the surgical techniques of correcting a deviated cartilaginous vault by creating a new center of the lower third using a caudal septal extension graft combined with unilaterally extended spreader grafts. Methods: This retrospective observational study was conducted in a university-based tertiary medical center from December 2014 to January 2018. Thirty-two patients who underwent primary open rhinoplasty for correction of a deviated nose using this method participated in the study. Patient characteristics and surgical records were collected. Anthropometric measurements and analyses were performed based on preoperative and postoperative photographs. The aesthetic outcome consensus of three rhinoplasty surgeons was evaluated specifically for nasal dorsum deviation correction. Postoperative complications were reviewed from the medical records. Results: Among the 32 patients, there were 18 males and 14 females. The mean (SD) age of the patients was 26.7 (8.76) years. Anthropometric measurements showed significant improvements in dorsal deviation angle (a 3.7° change towards midline, P < .001), nasal tip projection (increase of 6.96% measured by Goode’s method, P < .001), and nostril shape (nostril axis inclination decrease of 11.7°, P < .001) after surgery. The nasolabial angle showed no significant change. Aesthetic outcomes were excellent in seven patients (21.9%), good in fourteen patients (43.7%), fair in eight patients (25.0%), and no change in three patients (9.4%). Minor postoperative complications (four patients) were observed during follow-up. Conclusion: Centering the cartilaginous vault using a caudal septal extension graft combined with unilaterally extended spreader grafts is a useful technical option in the correction of a deviated nose, and provides improvement in nasal tip projection and nostril shape.

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.

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