Majid Rasti1, Sina Rasti2, Fatemeh Behshadnia3. 1. Plastic Surgeon Private Practice, 21 Mardavij street, Isfahan, Iran. 2. Isfahan University of Medical Science, 8174673461, Isfahan, Iran. 3. Isfahan University of Medical Science, 8174673461, Isfahan, Iran. fbehshadnia@gmail.com.
Abstract
BACKGROUND: Excessive nasal edema is among the complications after rhinoplasty translating into Skin-Soft Tissue Envelope (SSTE) thickening and disruption in the nasal framework's definition. Revision rhinoplasties are suspected of causing even more nasal edema. The objective postoperative SSTE thickness between revisionary and primary rhinoplasties is compared in this study. METHODS: A study was conducted over a recorded database of eligible candidates who had attended the senior author's private clinic in a 12-month period and underwent primary and revisionary open-approach rhinoplasties. The SSTE thickness was measured by ultrasonography in each nasion, rhinion, supratip, and tip region at months 1, 3, 6, and 12 after each episode of rhinoplasty. Paired T-test was used for pairwise comparisons of the corresponding region-time thicknesses between primary and revisionary rhinoplasties. Repeated measure ANOVA tests were used to assess mean thickness changes over time after each surgery-P < 0.05 indicated significance. RESULTS: Of the 36 participants analyzed, the SSTE was significantly thicker after revisionary surgery in all the follow-up sessions and nasal regions, except for the 1-month follow-up in the nasion (p = 0.273) and 12-month follow-up in the rhinion (p = 0.050). Mean nasal SSTE thickness showed decreasing trends in each region after either primary or revisionary surgery, with a lower level of resolution in the nasion region after revision rhinoplasty (p < 0.001). CONCLUSIONS: The nasal SSTE had been significantly thicker in most regions after revisionary procedures than primary ones, and the swelling had subsided slightly slower. Surgeons are recommended to consider revisionary rhinoplasties based on these findings cautiously. LEVEL OF EVIDENCE III: 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: Excessive nasal edema is among the complications after rhinoplasty translating into Skin-Soft Tissue Envelope (SSTE) thickening and disruption in the nasal framework's definition. Revision rhinoplasties are suspected of causing even more nasal edema. The objective postoperative SSTE thickness between revisionary and primary rhinoplasties is compared in this study. METHODS: A study was conducted over a recorded database of eligible candidates who had attended the senior author's private clinic in a 12-month period and underwent primary and revisionary open-approach rhinoplasties. The SSTE thickness was measured by ultrasonography in each nasion, rhinion, supratip, and tip region at months 1, 3, 6, and 12 after each episode of rhinoplasty. Paired T-test was used for pairwise comparisons of the corresponding region-time thicknesses between primary and revisionary rhinoplasties. Repeated measure ANOVA tests were used to assess mean thickness changes over time after each surgery-P < 0.05 indicated significance. RESULTS: Of the 36 participants analyzed, the SSTE was significantly thicker after revisionary surgery in all the follow-up sessions and nasal regions, except for the 1-month follow-up in the nasion (p = 0.273) and 12-month follow-up in the rhinion (p = 0.050). Mean nasal SSTE thickness showed decreasing trends in each region after either primary or revisionary surgery, with a lower level of resolution in the nasion region after revision rhinoplasty (p < 0.001). CONCLUSIONS: The nasal SSTE had been significantly thicker in most regions after revisionary procedures than primary ones, and the swelling had subsided slightly slower. Surgeons are recommended to consider revisionary rhinoplasties based on these findings cautiously. LEVEL OF EVIDENCE III: 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 .
Authors: Markus V Heppt; Michael C Kirchberger; Thomas Ruzicka; Carola Berking; Werner J Heppt Journal: Facial Plast Surg Date: 2018-02-06 Impact factor: 1.446
Authors: Amir A Sazgar; Alireza Majlesi; Saeideh Shooshtari; Mohammad Sadeghi; Amir K Sazgar; Amin Amali Journal: Aesthetic Plast Surg Date: 2018-10-04 Impact factor: 2.326