Craniomaxillofacial deformities/cosmetic surgery
An Analysis of 101 Primary Cosmetic Rhinoplasties

https://doi.org/10.1016/j.joms.2011.02.075Get rights and content

Purpose

Primary cosmetic rhinoplasty is one of the most complex of cosmetic surgical procedures in the maxillofacial area that requires precise consideration to both form and function. The complex and variable anatomy, highly visible position of the nose, and distinct patient desires contribute to the complexity of this procedure. This study reports the combined results of 101 consecutive primary cosmetic rhinoplasties at 2 centers.

Patients and Methods

A retrospective chart review was completed on all patients who had primary cosmetic rhinoplasty with or without septoplasty and who were operated on by the senior authors (S.C.B. and H.M.) from June 2006 through December 2008. A standard physical examination, including photo documentation, was completed on each patient preoperatively. All patients were followed periodically after surgery for at least 12 months. Outcome was measured by both subjective and objective measures of cosmetic and functional (breathing) outcome. The following data were collected and analyzed: age of patient, gender, chief cosmetic and functional complaint, details of surgical procedure (including septoplasty, grafts, and donor sites), complications, and report of subjective outcome at final evaluation.

Results

One hundred one patients (n = 101, average age 24.4 ± 6.8 years old) were enrolled in the study. Most patients presented for consultation regarding cosmetic rhinoplasty (80%) versus septorhinoplasty (20%). Although most of the patients (63%) were treated with septorhinoplasty, the open rhinoplasty (transcollumellar) incision was used in 61% of patients versus the closed rhinoplasty (39%) technique. The most commonly performed combination of techniques used was the combination of nasal tip modification, with dorsal reduction and nasal osetotomies (54%), followed by tip modification with dorsal reduction (19%), and dorsal reduction with osteotomies (18%) and no tip modification. In the 50 patients who required a graft, in 80% the donor site was the nasal septum. Spreader grafts were used in 14% of patients, and a combination of shield/tip graft was used in 52%. The following complications were observed: unhappy patient 16%, dehiscence at incision 5%, asymmetry requiring revision 6%, and infection 1%. In the 63 patients that had septoplasty, 6 (9.5%) reported that their breathing was not improved. In this series 11 patients (11%) received a revision rhinoplasty.

Conclusions

Primary cosmetic rhinoplasty is 1 of the more complex facial cosmetic procedures. The vast majority of complications can be avoided with careful and extensive treatment planning. In this series we found a complication and revision rate similar to that reported in the literature.

Section snippets

Patients and Methods

A retrospective chart review was completed on all patients who had primary cosmetic rhinoplasty with or without septoplasty and which were operated on by the senior authors (S.C.B. and H.M.) from June 30, 2006 through December 31, 2008. A standard physical examination, including photo documentation, was completed on each patient preoperatively. All patients were followed periodically after surgery for at least 12 months. Outcome was measured by both subjective and objective measures of cosmetic

Results

One hundred one patients (n = 101, average age 24.4 ± 6.8 years old, female = 62, males = 39) were enrolled in the study. Most patients presented for consultation regarding cosmetic rhinoplasty (80%) versus septorhinoplasty (20%). Although most of the patients (63%) were treated with septorhinoplasty, the open rhinoplasty (transcollumellar) incision was used in most cases (61%) versus the closed rhinoplasty (39%) technique. The most commonly performed operative technique used was the

Discussion

Rhinoplasty was traditionally developed as a cosmetic procedure to alter the shape of the nose via a closed (endonasal) surgical access. This technique has survived the test of time and continues to be a principal approach for many surgeons.3 In the past 3 decades many surgeons have embraced the open rhinoplasty approach via a transcollumellar incision. Although the literature may appear conflicting regarding the use of an open versus closed technique,4, 5, 6 both techniques can provide

References (15)

There are more references available in the full text version of this article.

Cited by (0)

View full text