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Nasal Tip Projection: Asymmetries after Rhinoplasty

Author(s): Gabriela Kopacheva-Barsova | Nikola Nikolovski | Maja Kirjas | Aleksandar Avramovski

Journal: Macedonian Journal of Medical Sciences
ISSN 1857-5749

Volume: 6;
Issue: 2;
Start page: 158;
Date: 2013;
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Keywords: Nasal tip asymmetries | rhinoplasty | facial planning | major secondary revision procedures | minor secondary revision procedures.

Background: Nasal tip projection has been defined as the distance along a perpendicular line from the vertical facial plane to the most anterior projecting point of the nasal tip. The tripod concept, although an oversimplification of nasal tip dynamics, highlights the intimate relationship between projection and rotation.Aim: The aim of the study was to evaluate the rate of nasal tip irregularities after the medial crura overlay procedure, and following the Tripoid concept.Methods: We completed a retrospective review of patients who have been admitted at ENT Clinic, Skopje from the period of 2008-2012. Operative technique rhinoplasty was prepared in 36 patients. Procedures included full-transfixion incision, release of tension septum, lateral crural overlay (LCO), dome truncation, medial crural overlay (MCO), and combinations of them. We reviewed major and minor secondary revision procedures that patients underwent, postoperative complications, and any functional complaints.Results: Of the remaining 36 patients: one (2.5%) required minor revision of dorsal irregularities, 3 (3.0%) required tip revision, 33 patients (93.3%) were satisfied without qualification, 3 patients (3.5%) were not satisfied and wont for revision surgery. Three patients (2.5%) underwent radix grafts. 5 (13.3%) of the patients had had previous rhinoplasty performed by another physicians. Seven patients (18.3%) were classified as having tension nose. One patient had postoperative epistaxis, and there were no cases of postoperative functional complaints.Conclusion: Our revision rate of 4.2% for tip irregularity and our finding that no patients had postoperative functional complaints allows us to feel confident that this algorithmic paradigm can be used to accomplish tip deprojection in almost any circumstance.
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