Advertisement

Novel method for correcting cephalic rotation in Asian nasal tip plasty

  • Author Footnotes
    1 Yiyu Sun and Gaoyang Wu contributed equally to this article and should be considered co–first authors.
    Yiyu Sun
    Footnotes
    1 Yiyu Sun and Gaoyang Wu contributed equally to this article and should be considered co–first authors.
    Affiliations
    Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    1 Yiyu Sun and Gaoyang Wu contributed equally to this article and should be considered co–first authors.
    Gaoyang Wu
    Footnotes
    1 Yiyu Sun and Gaoyang Wu contributed equally to this article and should be considered co–first authors.
    Affiliations
    Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
    Search for articles by this author
  • Zhaohua Jiang
    Affiliations
    Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
    Search for articles by this author
  • Weigang Cao
    Affiliations
    Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    2 Tingting Dai and Shengli Li are co-corresponding authors.
    Shengli Li
    Footnotes
    2 Tingting Dai and Shengli Li are co-corresponding authors.
    Affiliations
    Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    2 Tingting Dai and Shengli Li are co-corresponding authors.
    Tingting Dai
    Correspondence
    Corresponding author at: 639 Zhi Zao Ju Road, Shanghai, China.
    Footnotes
    2 Tingting Dai and Shengli Li are co-corresponding authors.
    Affiliations
    Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    1 Yiyu Sun and Gaoyang Wu contributed equally to this article and should be considered co–first authors.
    2 Tingting Dai and Shengli Li are co-corresponding authors.
Published:October 13, 2022DOI:https://doi.org/10.1016/j.bjps.2022.10.003

      Summary

      Background

      To correct nasal tip cephalic rotation, SEG made of cartilage or Medpor are often used in rhinoplasty. These techniques require extensive experience for the surgeon, and not all patients can accept this procedure. In this research, we introduce a new method to correct nasal tip cephalic rotation that is relatively simple and rapid.

      Methods

      Fifty-nine patients who had rhinoplasty using our scaffold were enrolled in the study between January 2020 and January 2021. The authors evaluated the change of nasolabial angel by photogrammetry using standardized clinical photogrammetric techniques. Patients’ satisfaction regarding postoperative results was also surveyed.

      Results

      The mean postoperative follow-up duration was 12 months. No complication (infection, extrusion, and displacement) was happened in all patients. Analysis showed our scaffold can correct nasal tip cephalic rotation effectively (98.61±1.21 preoperatively and 89.68±0.99 postoperatively, P<0.0001). And the patient satisfaction rate is 98%.

      Conclusion

      We constructed an integrated scaffold by simply folding and suturing a high-density polyethylene sheet (Su-Por) sheet to correct nasal tip cephalic rotation. Using the scaffold we designed, we did not need to alter the structure of the nasal septum, which reduced the operative duration and simplified the surgical procedure.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Jang Y.J.
        • Alfanta E.M.
        Rhinoplasty in the Asian nose.
        Facial Plast Surg Clin North Am. 2014; 22: 357-377
        • Lovice D.B.
        • Mingrone M.D.
        • Toriumi D.M.
        Grafts amd implants in rhinoplasty and nasal reconstruction.
        Otolaryngol Clin North Am. 1999; 32: 113-141
        • Sajjadian A.
        • Rubinstein R.
        • Naghshineh N.
        Current status of grafts and implants in rhinoplasty: Part I. Autologous grafts.
        Plast Reconstr Surg. 2010; 125 (40e–49e)
        • Jin H.R.
        • Won T.B.
        Rhinoplasty in the Asian patient.
        Clin Plast Surg. 2016; 43: 265-279
        • Miles B.A.
        • Petrisor D.
        • Kao H.
        • Finn R.A.
        • Throckmorton G.S.
        Anatomical variation of the nasal septum: Analysis of 57 cadaver specimens.
        Otolaryngol Head Neck Surg. 2007; 136: 362-368
        • Park J.H.
        • HR Jin
        Use of autologous costal cartilage in Asian rhinoplasty.
        Plast Reconstr Surg. 2012; 130: 1338-1348
        • Zhang S.
        • Zhen J.
        • Li H.
        • et al.
        Characteristics of Chinese costal cartilage and costa calcification using dual-energy computed tomography imaging.
        Sci Rep. 2017; 7: 2923
        • Niechajev I.
        Porous polyethylene implants for nasal reconstruction: Clinical and histologic studies.
        Aesthetic Plast Surg. 1999; 23: 395-402
        • Sclafani A.P.
        • Thomas J.R.
        • Cox A.J.
        • Cooper M.H.
        Clinical and histologic response of subcutaneous expanded polytetrafluoroethylene (Gore-Tex) and porous high-density polyethylene (Medpor) implants to acute and early infection.
        Arch Otolaryngol Head Neck Surg. 1997; 123: 328-336
        • Niechajev I.
        Facial reconstruction using porous high-density polyethylene (Medpor): Long-term results.
        Aesthetic Plast Surg. 2012; 36: 917-927
        • Sajjadian A.
        • Naghshineh N.
        • Rubinstein R.
        Current status of grafts and implants in rhinoplasty: Part II. Homologous grafts and allogenic implants.
        Plast Reconstr Surg. 2010; 125 (99e–109e)
        • Peled Z.M.
        • Warren A.G.
        • Johnston P.
        • Yaremchuk M.J.
        The use of alloplastic materials in rhinoplasty surgery: A meta-analysis.
        Plast Reconstr Surg. 2008; 121 (85e–92e)
        • Choi J.Y.
        Complications of alloplast rhinoplasty and their management: A comprehensive review.
        Facial Plast Surg. 2020; 36: 517-527
        • Lewin S.
        Complications after total porous implant ear reconstruction and their management.
        Facial Plast Surg. 2015; 31: 617-625
        • Walton R.L.
        • Seelaus R.
        • Robinson B.R.
        Subtotal nasal reconstruction using a custom 3-dimensional porous polyethylene construct.
        Plast Reconstr Surg Glob Open. 2019; 7: e2568
        • Li J.
        • Huang Y.
        • Zhang Y.
        • Pu Z.
        Application of a porous polyethylene spreader graft for nasal lengthening in Asian patients.
        Aesthet Surg J. 2018; 38: 491-499
        • Mizuno T.
        A new technique for augmentation rhinoplasty using hybrid autologous grafts with septal extension grafts in Asian patients.
        Facial Plast Surg. 2019; 35: 58-64
        • Kim H.I.
        • Lee W.J.
        • Roh T.S.
        • Suh M.K.
        A novel technique of Asian tip plasty: Rein-shaped columellar strut graft.
        Aesthetic Plast Surg. 2019; 43: 1301-1309
        • Wang L.
        • Niu Y.
        • Zhang H.
        • Li B.
        Reinforcement of lower lateral cartilage using sliced costal periphery to reconfigure nasal tip in Asian rhinoplasty.
        J Craniofac Surg. 2018; 29: 1212-1215
        • Bucher S.
        • Kunz S.
        • Deggeller M.
        • Holzmann D.
        • Soyka M.B.
        Open rhinoplasty using a columellar strut: Effects of the graft on nasal tip projection and rotation.
        Eur Arch Otorhinolaryngol. 2020; 277: 1371-1377
        • Sawh-Martinez R.
        • Perkins K.
        • Madari S.
        • Steinbacher D.M.
        Control of nasal tip position: Quantitative assessment of columellar strut versus caudal septal extension graft.
        Plast Reconstr Surg. 2019; 144 (772e–780e)
        • Rohrich R.J.
        • Durand P.D.
        • Dayan E.
        Changing role of septal extension versus columellar grafts in modern rhinoplasty.
        Plast Reconstr Surg. 2020; 145 (927e–931e)
        • Rohrich R.J.
        • Kurkjian T.J.
        • Hoxworth R.E.
        • Stephan P.J.
        • Mojallal A.
        The effect of the columellar strut graft on nasal tip position in primary rhinoplasty.
        Plast Reconstr Surg. 2012; 130: 926-932
        • Anderson J.R.
        A new approach to rhinoplasty.
        Trans Am Acad Ophthalmol Otolaryngol. 1966; 70: 183-192
        • Westreich R.W.
        • Courtland H.W.
        • Nasser P.
        • Jepsen K.
        • Lawson W.
        Defining nasal cartilage elasticity: Biomechanical testing of the tripod theory based on a cantilevered model.
        Arch Facial Plast Surg. 2007; 9: 264-270
        • Sen C.
        • Iscen D.
        Caudal septal advancement for nasal tip projection and support in rhinoplasty.
        Aesthetic Plast Surg. 2006; 30: 135-140
        • Adams Jr., W.P.
        • Rohrich R.J.
        • Hollier L.H.
        • et al.
        Anatomic basis and clinical implications for nasal tip support in open versus closed rhinoplasty.
        Plast Reconstr Surg. 1999; 103 (discussion 62-4): 255-261
        • Han K.
        • Jeong J.W.
        • Kim J.H.
        • et al.
        Complete septal extension grafts using porous high-density polyethylene sheets for the westernization of the Asian nose.
        Plast Reconstr Surg. 2012; 130 (106e–115e)
        • Kim Y.H.
        • Kim B.J.
        • Jang T.Y.
        Use of porous high-density polyethylene (Medpor) for spreader or extended septal graft in rhinoplasty: Aesthetics, functional outcomes, and long-term complications.
        Ann Plast Surg. 2011; 67: 464-468
        • Hwang N.H.
        • Dhong E.S.
        Septal extension graft in Asian rhinoplasty.
        Facial Plast Surg Clin North Am. 2018; 26: 331-341
        • Sclafani A.P.
        • Romo 3rd, T.
        • Silver L.
        Clinical and histologic behavior of exposed porous high-density polyethylene implants.
        Plast Reconstr Surg. 1997; 99: 41-50
        • Teymoortash A.
        • Fasunla J.A.
        • Sazgar A.A.
        The value of spreader grafts in rhinoplasty: A critical review.
        Eur Arch Otorhinolaryngol. 2012; 269: 1411-1416
        • Goudakos J.K.
        • Fishman J.M.
        • Patel K.
        A systematic review of the surgical techniques for the treatment of internal nasal valve collapse: Where do we stand?.
        Clin Otolaryngol. 2017; 42: 60-70
        • Raghavan U.
        • Ullas G.
        • Daoud M.
        Mathematical analysis of the functions of spreader graft.
        Plast Reconstr Surg. 2020; 146 (698e–700e)
        • Papadopulos A.
        • Harada C.
        Compound implant to project the nasal tip.
        Aesthetic Plast Surg. 1987; 11: 181-185
        • Yanaga H.
        • Imai K.
        • Yanaga K.
        Generative surgery of cultured autologous auricular chondrocytes for nasal augmentation.
        Aesthetic Plast Surg. 2009; 33: 795-802