![[ Visit Client Website ]](images/banner.gif)
Sunday, September 25, 2011: 10:40 AM
Colorado Convention Center
Background: The aesthetically pleasing nose relies heavily on tip shape and projection, which is determined by the length of the medial and lateral crura. In reducing or controlling tip projection, resecting the medial crura has been considered radical and infrequently used. However, with increasing experience over 15 years, we believe that purposeful transection and resection of the medial crura affords the plastic surgeon the ultimate freedom in controlling postoperative tip projection and shape. Here we present our series of consecutive patients in which purposeful resection and manipulation of the medial crura was performed safely with excellent results.
Methods: This is a single institution, retrospective review of all consecutive patients who underwent rhinoplasty with resection of the medial crura by a single surgeon from 1999 – 2009.
Results: 115 patients underwent resection of the medial crura during open rhinoplasty from 1999-2009 at a single institution. Mean age was 35 ± 12years old. There were 100 females (87%) and 15 male (13%). 76 (66%) patients suffered from varying degrees of nasal obstruction preoperatively and 40 (35%) had evidence of septal deviation. Ten (9%) had a history of prior trauma to the nose. 97 (84%) patients had significant cosmetic concerns. 31 patients (27%) had a history of a prior rhinoplasty procedure. All cases were performed using an open technique under conscious sedation anesthesia in 99% of cases. In addition to resection of the medial crura, all patients received a columellar strut. 99 (86%) patients underwent septoplasty, thirteen (11%) patients had spreader grafts inserted and five (4%) patients had a tip graft placed. In addition to a rhinoplasty, 44 (38%) patients underwent an additional procedure, including augmentation mammaplasty, mastopexy, rhytidectomy, brow lift, blepharoplasty, and fat grafting. There were 5 complications in this series (4%), none of which were related to tip collapse. There were two cases of infection treated with oral antibiotics, 1 case of intranasal suture dehiscence, 1 case of persistent breathing complaints, and 1 cosmetic concern postoperative requiring revisional rasping of the nasal dorsum. Postoperative cosmesis was considered excellent in all cases.
Conclusion: Resection of the medial crura can be performed safely during rhinoplasty procedures. And in select cases, this technique affords the surgeon the greatest freedom in controlling postoperative nasal tip projection.
Methods: This is a single institution, retrospective review of all consecutive patients who underwent rhinoplasty with resection of the medial crura by a single surgeon from 1999 – 2009.
Results: 115 patients underwent resection of the medial crura during open rhinoplasty from 1999-2009 at a single institution. Mean age was 35 ± 12years old. There were 100 females (87%) and 15 male (13%). 76 (66%) patients suffered from varying degrees of nasal obstruction preoperatively and 40 (35%) had evidence of septal deviation. Ten (9%) had a history of prior trauma to the nose. 97 (84%) patients had significant cosmetic concerns. 31 patients (27%) had a history of a prior rhinoplasty procedure. All cases were performed using an open technique under conscious sedation anesthesia in 99% of cases. In addition to resection of the medial crura, all patients received a columellar strut. 99 (86%) patients underwent septoplasty, thirteen (11%) patients had spreader grafts inserted and five (4%) patients had a tip graft placed. In addition to a rhinoplasty, 44 (38%) patients underwent an additional procedure, including augmentation mammaplasty, mastopexy, rhytidectomy, brow lift, blepharoplasty, and fat grafting. There were 5 complications in this series (4%), none of which were related to tip collapse. There were two cases of infection treated with oral antibiotics, 1 case of intranasal suture dehiscence, 1 case of persistent breathing complaints, and 1 cosmetic concern postoperative requiring revisional rasping of the nasal dorsum. Postoperative cosmesis was considered excellent in all cases.
Conclusion: Resection of the medial crura can be performed safely during rhinoplasty procedures. And in select cases, this technique affords the surgeon the greatest freedom in controlling postoperative nasal tip projection.