Background: Nasal tip support mechanism plays an important
role in maintaining tip in its position and preventing
drooping of nasal tip and nasal lengthening. In rhinoplasty
surgery, this mechanism can be excised or detached during
different steps of rhinoplasty, in our practice we detach three
attachments which play an important role in tip support;
attachment in-between the caudal septum and foot plates of
medial crura which can be replaced by medial crural septal
suture, interdomal attachment also can be replaced by interdomal
suturing, while the attachment in-between upper and
lower lateral cartilages, which is usually detached during
cephalic trimming of the lower lateral cartilage, is not replaced
by any type of suturing technique. In this study, we described
a new intercartilaginous suturing technique to reattach this
attachment with the remaining part of lower lateral cartilage.
We aimed to analyze the log-term effect of re-attachment of
the ligament between upper and lower lateral cartilages on
tip support, projection and rotation.
Material and Methods: Twenty four patients were included
in this study; group I included 12 patients had underwent
aesthetic rhinoplasty surgery without applying intercartilaginous
suture, while in group II, the new suture was
applied in 12 patients during rhinoplasty. In both groups,
nasolabial angle and projection/ nasal length ratio in the
profile view of patients' photographs were measured at 1.5,
3 and 6 months post-operatively as well as, patient's satisfaction
regarding aesthetic outcome was subjectively evaluated by a
questionnaire at 6 months post-operatively.
Results: The study revealed that nasal tip position was
maintained in group II more than group I in a period of 6
months following rhinoplasty surgery with more patient
satisfaction score in group II of patients as well.
Key Words: Primary rhinoplasty – Open rhinoplasty