Abstract
BackgroundA deviated nose is a very common developmental feature in Caucasian populations and represents a frequent indication for rhinoplasty, either functional or esthetic. We aim to assess the pattern of nasal axis stabilization after rhinoplasty in the deviated nose on the basis of anthropometric measurements: median face axis (MFA), interpupillary meridian axis (IMA), and scoliosis angle (SA); to study possible effects of rigging the nose in the midfacial soft tissues using absorbable soft sutures; to investigate possible side effects.MethodsSeventy patients with a non-traumatic deviated nose (n = 50 as control group, n = 20 as treated group with placement of barbed suture in the midfacial soft tissues) underwent rhinoplasty procedures. We retrospectively examined the pattern of deviation recurrence over time in a consecutive series of 70 non-traumatic patients undergoing primary esthetic or functional rhinoplasty (n = 50 as control group, n = 20 as treated group with placement of barbed suture in the midfacial soft tissues). Patients were followed up at 1 week, 2 weeks, 1 month, 3 months, and 1 year postoperatively.ResultsNinety-three percent (65/70) of the patients had an asymmetric face after comparing the two anthropometric angles MFA and IMA. Overcorrection of NA at one week postoperatively was observed in 1.25% and 35.7% of patients in the control and treated groups, respectively (p = 0.006). MFA shifted from 4.16° ± 3.1° preoperatively to 1.2° ± 1.4° at 1 week, 1.0° ± 1.1° at 2 weeks, 1.1° ± 1.4° at 1 month, 1.1° ± 1.5° at 3 months, and 1.7° ± 2° at 1 year in the control group. In the treated group, MFA shifted from 5.7° ± 2.9 preoperatively to − 0.34° ± 2.9° at 1 week, 1.0° ± 1.1° at 2 weeks, 0.59° ± 0.96° at 1 month, 1.22° ± 0.83° at 3 months, and 1.63° ± 0.8° at 1 year. Differences between the groups were significant at 1 week (p = 0.02), but differences were not significant at 2 weeks, 1 month, 3 months, and 1 year.ConclusionsThis pilot study demonstrates that the progressive re-deviation pattern is altered during the first weeks after surgery in the barbed sutures group. Absorbable barbed sutures in facial soft tissues are well tolerated. Longer lasting sutures may help to obtain definite advantage.Level of evidence: Level IV, therapeutic study.
Highlights
A deviated nose is a very common developmental feature in Caucasian populations and represents a frequent indication forThe results of this study have been presented by Yves LJ Goffart at the 12th International Symposium of Facial Plastic Surgery on October 17, 2018, Dallas, TX.Nasal axis (NA) deviations are classified as linear, C-shaped, or Sshaped
50 patients were included in the control group, and 20 patients were included in the barbed suture treatment group
Among the 70 enrolled patients, interpupillary meridian axis (IMA) and median face axis (MFA) significantly differed in 65 patients (93%) at baseline (p = 0.026)
Summary
A deviated nose is a very common developmental feature in Caucasian populations and represents a frequent indication forThe results of this study have been presented by Yves LJ Goffart at the 12th International Symposium of Facial Plastic Surgery on October 17, 2018, Dallas, TX.NA deviations are classified as linear, C-shaped, or Sshaped. Most patients with a non-traumatic deviated nose present with an asymmetric face [3, 6, 7, 12] This asymmetry is present both in the maxillary support and in facial soft tissues. The resulting imbalance between the sides of the face will even increase with facial expressions It is unclear whether these tensile forces in facial soft tissues, fascia, and muscles play a role in the progressive re-deviation process over several months until healing of bony and cartilaginous structures is completed and definitive stretching of soft tissues is obtained [3]. A deviated nose is a very common developmental feature in Caucasian populations and represents a frequent indication for rhinoplasty, either functional or esthetic. We aim to assess the pattern of nasal axis stabilization after rhinoplasty in the deviated nose on the basis of anthropometric measurements: median face axis (MFA), interpupillary meridian axis (IMA), and scoliosis angle (SA); to study possible effects of rigging the nose in the midfacial soft tissues using absorbable soft sutures; to investigate possible side effects
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