BACKGROUND: The aim of this study was to compare the degree of nasal tip rigidity from different techniques for increasing nasal tip projection. METHODS: Retrospective records of patients who had undergone rhinoplasty were reviewed at the tertiary referral center. 81 patients who had undergone suturing of the medial crura to the extension graft or to the long septum were selected. In group A, fixation was performed at the same level compared to before surgery. In group B, tip grafting was performed to gain 3 mm or more in projection after fixation as done in group A. In group C, the same tip projection was provided by advancing the medial crura on the caudal septum or extension graft. Patients were evaluated with a visual analog scale, based on the rigidity of the nasal tip (0=very flexible, 10=very rigid). RESULTS: When the preoperative and postoperative VAS scores of all groups were compared, postoperative scores were significantly higher than the preoperative scores (p<0.001). The postoperative scores of group C were higher than those of the other groups. These differences were statistically significant (p<0.001). There was no statistically significant difference between groups A and B with regard to the postoperative scores (p=0.389). However, in group C, the increase between preoperative and postoperative scores was significantly higher than in the other groups (p<0.001). CONCLUSION: Advancing the medial crura on the caudal septum and suturing to gain 3 mm or more of tip projection may result in a more rigid nasal tip. Patients should be informed preoperatively of this potential result. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
BACKGROUND: The aim of this study was to compare the degree of nasal tip rigidity from different techniques for increasing nasal tip projection. METHODS: Retrospective records of patients who had undergone rhinoplasty were reviewed at the tertiary referral center. 81 patients who had undergone suturing of the medial crura to the extension graft or to the long septum were selected. In group A, fixation was performed at the same level compared to before surgery. In group B, tip grafting was performed to gain 3 mm or more in projection after fixation as done in group A. In group C, the same tip projection was provided by advancing the medial crura on the caudal septum or extension graft. Patients were evaluated with a visual analog scale, based on the rigidity of the nasal tip (0=very flexible, 10=very rigid). RESULTS: When the preoperative and postoperative VAS scores of all groups were compared, postoperative scores were significantly higher than the preoperative scores (p<0.001). The postoperative scores of group C were higher than those of the other groups. These differences were statistically significant (p<0.001). There was no statistically significant difference between groups A and B with regard to the postoperative scores (p=0.389). However, in group C, the increase between preoperative and postoperative scores was significantly higher than in the other groups (p<0.001). CONCLUSION: Advancing the medial crura on the caudal septum and suturing to gain 3 mm or more of tip projection may result in a more rigid nasal tip. Patients should be informed preoperatively of this potential result. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .