Nasal Tip Volume Analysis After Butterfly Graft

Abstract

The aim of the study was to evaluate postoperative changes of the nasal tip in patients who underwent internal nasal valve reconstruction with the auricular cartilage butterfly graft. It is believed that this graft may alter the nasal tip appearance, potentially limiting the technique's broad use despite its proven efficacy. A retrospective chart and photograph review, between 2005 and 2009, identified 157 patients who underwent butterfly grafting without other tip modifications at a single institution by 1 surgeon. Changes in supratip projection were measured in the lateral view, and changes in tip width were measured in the frontal view from preoperative to 3-month postoperative photographs. For 21 subjects (12 female and 9 male), the change in tip width ranged from -10.2% to +15.7% (absolute mean 6.4%), and the change in supratip projection ranged from -23.4% to +15.0% (absolute mean 8.5%). Nine subjects with increased projection showed a mean increase of 7.0%, and a mean decrease of 9.7% was found in the 12 subjects with decreased supratip projection. The butterfly graft for internal nasal valve dysfunction results in cosmetic alteration to nasal tip width with a mean change of 6.4%. The change in supratip projection showed greater variability possibly related to purposeful cosmetic changes. Depending on the patient's level of nasal dysfunction, the 6.4% mean change in nasal tip width may be more or less personally significant.