Complications Of Rhinoplasty Research Articles

Symposium: the supra-tip in rhinoplasty: a dilemma. II. Influence of surrounding structure and prevention.

One of the most annoying complications of rhinoplasty is the supra-tip hump (pollybeak). Possible causes are failure to surgically compensate for: 1. The increased skin thickness above the tip. 2. Supra-tip keloid tendency. 3. Overactive depressor septi muscles. 4. Loss of natural tip support by the upper lateral cartilages and septum.

The complications of augmentation rhinoplasty in orientals

Augmentation rhinoplasty is one of the most popular plastic operations in Japan. Most plastic surgeons use of prosthesis for this purpose instead of autogenous material such as cartilage or bone. In my experience, bone and cartilage have been safely used, but frequently we have seen absorption with loss of weight. In addition, the procedures required to obtain the grafts transform a minor into a major operation.

Rhinoplasty tip ptosis: etiology and prevention.

AbstractCommonly, 12‐18 months must elapse before the final postoperative result following rhinoplasty may be judged. Unless actively compensated for during surgery, an inconstant degree of nasal tip ptosis (“settling”) may lead to displeasing nasal profile characteristics. Supra‐tip rounding accentuates tip ptosis, creating the undesirable “pollybeak” deformity. Generally, these two complications of rhinoplasty are predictable and preventable, providing that their various etiologies are clearly understood.Nasal tip ptosis in the postoperative healing period occurs if false projection of the tip confuses the surgeon. Operative tip swelling (infiltration anesthesia and edema) along with malpositioned columellar “bunching” sutures and “orthopedic” septocolumellar sutures create spurious tip projection. Loss of normal tip support occurs when incisions interrupt the attachment of the lower lateral cartilages to the upper lateral cartilages as well as the “wrap‐around” relationship of the feet of the medial crura to the caudal cartilaginous septum. Complete transfixion incisions should be avoided when possible. Cartilaginous or bony shoring struts increase tip support. Modeling of the lower lateral cartilage should not include over‐generous removal of the lateral crura, thus further weakening tip support.Unfavorable healing factors contributing to tip ptosis include linear contraction of the transfixion incision scar, the natural downward torque influence of the lower lateral cartilages, and detrimental synergistic activity of specific muscles of facial expression.Tip ptosis may accentuate the undesirable formation of supra‐tip prominence, thus unmasking the eventual stigma of “pollybeak” deformity. Supra‐tip prominence may develop as the result of:1. Inadequate lowering of cartilaginous dorsal hump.2. Inadequate lowering of upper lateral cartilages.3. Insufficient nasal skin undermining.4. Failure to excise adequately redundant mucous membrane projecting above the newly‐established profile line.5. Inadequate tip splinting.Preventive operative maneuvers can reduce the incidence of displeasing profile relationships, leading to a natural and harmonious postoperative rhinoplasty appearance.

Complications of Rhinoplasty. I. Skin and Subcutaneous Tissues

Plastic and Reconstructive Surgery and the Transplantation Bulletin: December 1958 - Volume 22 - Issue 6 - p 574

Operative complications of rhinoplasty.

Operative complications of rhinoplasty.