At least twice a month, PRSonally Speaking posts full abstracts of interesting or potentially controversial articles from a future issue. This 'sneak preview' of a hot article is meant to give you some food for thought and provide you with topic for conversation among colleagues.
When the article is published in print with the February issue, it will be FREE for a period of Two Months, to help the conversation continue in the PRS community and beyond. So read the abstract, join the conversation and spread the word.
This week we present the introduction to "Smile Analysis in Rhinoplasty: A Randomized Study for Comparing Resection and Transposition of the Depressor Septi Nasi Muscle" by Arash Beiraghi-Toosi et al.
Background: Depressor septi nasi (DSN) muscle is responsible for smiling deformity. Its manipulation is beneficial in patients with muscle hypertrophy. Besides, it enhances the smile and tip-lip relationship. In this study, DSN excision through transfixion incision is compared with its transposition through upper labial sulcus incision.
Methods: Two techniques of DSN treatment were randomly performed for rhinoplasty cases. "Smile analysis in rhinoplasty" consisted of measurements of nasal length, nasal diagonal, tip projection, upper lip height and noting transverse upper labial crease in repose and full smile was performed on preoperative and postoperative photographs.
Results: One hundred patients were studied in two equal groups. Preoperatively, tip projection and upper lip height were significantly decreased with smile. Generally, the effect of smiling on all 5 parameters was significantly decreased following rhinoplasty. The two different techniques were not significantly different in decreasing the effects of smile on nasal length, nasal diagonal, tip projection, upper lip height and transverse crease.
Conclusions: The two different techniques were the same in decreasing the effects of smile. We recommend "smile analysis in rhinoplasty" consisted of measurement of nasal length, nasal diagonal, tip projection, upper lip height and noting transverse upper labial crease in repose and smiling before rhinoplasty for preoperative evaluation and after the operation for outcome assessment. DSN treatment should be considered if decrease in tip projection or upper lip height with smile or a transverse upper labial crease during smile is extraordinary or unsightly.