O Onur Erol1. 1. ONEP Plastic Surgery Science Institute, Istanbul, Turkey. onurerolmd@onep.com.tr
Abstract
BACKGROUND: Historically, one of the most persistent challenges to the rhinoplasty surgeon has been the thick, heavy, and poorly defined nasal tip. In the Mediterranean, Anatolian, and Middle Eastern regions, rhinoplasty is the most frequently performed aesthetic procedure. In these regions, the ethnic characteristic of the nasal tip is mostly broad with thick skin, a poorly defined nasal tip, and weak lower lateral cartilages, which makes shaping the tip challenging. In this population, conventional rhinoplasty techniques may result in dissatisfied patients and surgeons. METHODS: The author presents his experience over the past 20 years with 3800 rhinoplasty patients with broad noses treated using his personal approach. RESULTS: Using the Turkish delight type of cartilage graft (diced cartilage wrapped in Surgicel) for the tip region and the columellar strut improved the author's results considerably, giving the tip the desired form and eliminating the complications of late show seen in other types of tip grafts. In patients with very short columellae, insertion of a secondary strut was necessary after 1 year. CONCLUSIONS: : This technique is safe, reliable, effective, simple, and easily applicable by plastic surgeons at all experience levels. Early and late results are very satisfactory, and there is no late show as is sometimes seen with other types of cartilage grafts such as crushed, oval, or rectangular grafts. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
BACKGROUND: Historically, one of the most persistent challenges to the rhinoplasty surgeon has been the thick, heavy, and poorly defined nasal tip. In the Mediterranean, Anatolian, and Middle Eastern regions, rhinoplasty is the most frequently performed aesthetic procedure. In these regions, the ethnic characteristic of the nasal tip is mostly broad with thick skin, a poorly defined nasal tip, and weak lower lateral cartilages, which makes shaping the tip challenging. In this population, conventional rhinoplasty techniques may result in dissatisfied patients and surgeons. METHODS: The author presents his experience over the past 20 years with 3800 rhinoplasty patients with broad noses treated using his personal approach. RESULTS: Using the Turkish delight type of cartilage graft (diced cartilage wrapped in Surgicel) for the tip region and the columellar strut improved the author's results considerably, giving the tip the desired form and eliminating the complications of late show seen in other types of tip grafts. In patients with very short columellae, insertion of a secondary strut was necessary after 1 year. CONCLUSIONS: : This technique is safe, reliable, effective, simple, and easily applicable by plastic surgeons at all experience levels. Early and late results are very satisfactory, and there is no late show as is sometimes seen with other types of cartilage grafts such as crushed, oval, or rectangular grafts. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Authors: Fouad Mohammed Ghareeb; Ahmed Tharwat Nassar; Ahmed Abdelaziz Talaab; Sherief Alkashty Journal: Plast Reconstr Surg Glob Open Date: 2018-10-22