Summary
Background
Tip ptosis is a relatively common nasal deformity, with an incidence as high as 72%
in rhinoplasty patients. Different techniques were described for surgical correction
of the droopy tip, such as the lateral crural steel, the lateral crural overlay, the
tongue-in-groove technique and others. Most authors agreed that an external rhinoplasty
approach is necessary for effectively conducting the alar cartilage-modifying techniques
mentioned above.
Methods
In this article we challenge this paradigm and introduce an efficient method for aesthetic
correction of severe tip ptosis through an internal rhinoplasty approach. Twenty-three
patients with severe ptosis of the nasal tip were operated on by the senior author
(MH) between 2000 and 2005 using the described technique. After carrying out the necessary
manœuvres to achieve the desired tip rotation (reduction of cephalic border of alar
cartilages, modification of the caudal septum, reduction of upper lateral cartilages),
the desired tip position was maintained with the horizontal columellar strut, whose
initial operative description appears here.
Results
The desired rotation and projection were maintained in all but three patients over
the first year after the surgery. In three patients we observed some loss of tip projection
after 1 year. We did not witness complications directly related to the horizontal
columellar strut.
Conclusion
The horizontal columellar strut is an efficient tool for stabilising the corrected
position of a severely ptotic nasal tip. We recommend adding the horizontal columellar
strut to the array of available rhinoplasty techniques.
Keywords
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References
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Article info
Publication history
Published online: January 02, 2007
Accepted:
October 20,
2006
Received:
February 20,
2006
Identification
Copyright
© 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
