Krzysztof Conrad1, Adi Yoskovitch. 1. Department of Otolaryngology, University of Toronto, Toronto, Ontario, Canada. info@drkconrad.com
Abstract
BACKGROUND: Supratip fullness, also known as pollybeak deformity, is one of the most common postoperative complications of rhinoplasty. The deformity can result from many different causes, some of which are related to the surgical technique and can be prevented. Poor redraping of thick, inelastic skin and thick subcutaneous tissues over the reduced cartilaginous framework may result in the creation of a subcutaneous "dead space," leading to the formation of excessive subcutaneous scar and a soft tissue pollybeak in some cases. OBJECTIVE: To evaluate the effectiveness of a homologous fibrin glue (Tisseel; Baxter AG, Vienna, Austria) in the prevention and correction of the soft tissue pollybeak deformity. DESIGN: Prospective study. PATIENTS AND METHODS: Thirty patients were treated with fibrin glue to achieve better adherence of the skin to the underlying skeletal framework. Ten patients had no previous nasal surgery. The remaining 20 patients presented with the complication of pollybeak deformity. In this group, 14 patients had undergone 1 previous surgical procedure, 3 had undergone 3 previous rhinoplasties, and 3 had undergone 4 or more previous procedures. RESULTS: There were no intraoperative or postoperative complications. Follow-up ranged from 2 to 34 months, with all patients achieving successful aesthetic outcomes. CONCLUSION: Fibrin glue is an excellent adjunct to rhinoplasty procedures because it successfully eliminates the dead space that can cause soft tissue pollybeak deformity.
BACKGROUND: Supratip fullness, also known as pollybeak deformity, is one of the most common postoperative complications of rhinoplasty. The deformity can result from many different causes, some of which are related to the surgical technique and can be prevented. Poor redraping of thick, inelastic skin and thick subcutaneous tissues over the reduced cartilaginous framework may result in the creation of a subcutaneous "dead space," leading to the formation of excessive subcutaneous scar and a soft tissue pollybeak in some cases. OBJECTIVE: To evaluate the effectiveness of a homologous fibrin glue (Tisseel; Baxter AG, Vienna, Austria) in the prevention and correction of the soft tissue pollybeak deformity. DESIGN: Prospective study. PATIENTS AND METHODS: Thirty patients were treated with fibrin glue to achieve better adherence of the skin to the underlying skeletal framework. Ten patients had no previous nasal surgery. The remaining 20 patients presented with the complication of pollybeak deformity. In this group, 14 patients had undergone 1 previous surgical procedure, 3 had undergone 3 previous rhinoplasties, and 3 had undergone 4 or more previous procedures. RESULTS: There were no intraoperative or postoperative complications. Follow-up ranged from 2 to 34 months, with all patients achieving successful aesthetic outcomes. CONCLUSION: Fibrin glue is an excellent adjunct to rhinoplasty procedures because it successfully eliminates the dead space that can cause soft tissue pollybeak deformity.