Secondary Logo

Institutional members access full text with Ovid®

Defining a New Variable That May Impact Long-term Postoperative Nasal Tip Support

The Biomechanical Properties of the Columellar Strut Graft

Sezgin, Billur, MD*; Guney, Kirdar, MD; Lazoglu, Ismail, PhD; Tatar, Sedat, MD*; Layegh, Ehsan, PhD; Ozel, Melis*; Ozmen, Selahattin, MD*; Yavuzer, Reha, MD*‡

doi: 10.1097/SAP.0000000000001600

Background Although columellar strut grafts (CSGs) are considered among the fundamental steps for providing nasal tip support, a downward rotation of the nasal tip in patients with strut grafts can still be encountered. Patient-related factors such as nasal skin thickness can allow the plastic surgeon to anticipate certain drawbacks that can be encountered in the healing phase, but patient-based differences of nasal cartilage and the resulting impact have yet to be investigated. The purpose of this study was to evaluate the effect of the biomechanical properties of CSGs on late postoperative nasal tip position and support.

Methods The study was undertaken with the participation of 20 patients undergoing closed-technique primary rhinoplasty with CSGs. Each cartilage specimen was biomechanically analyzed to calculate the modulus of elasticity. Preoperative and postoperative images were obtained to determine nasal tip position and rotation with quantitative measurements. Postoperative 3- and 12-month measurements were evaluated according to their relationship with the elasticity modulus of the utilized cartilages.

Results The evaluation demonstrated that the elasticity modulus can impact the long-term support of the nasolabial angle in which an increase in the coefficient of elasticity can result in a decrease in long-term nasal tip support.

Conclusion The results of the study reveal a new objective variable that can impact nasal tip dynamics and patient-related differences following rhinoplasty. This study not only brings forth a different perspective in the evaluation of nasal tip dynamics but can also provide data for determining ideal values for cartilage prefabrication.

From the *Department of Plastic, Reconstructive and Aesthetic Surgery, Koç University School of Medicine;

Department of Mechanical Engineering, Koç University School of Engineering; and

Renee Clinic, Istanbul, Turkey.

Received May 9, 2018, and accepted for publication, after revision July 3, 2018.

Conflicts of interest and sources of funding: none declared.

This study has been presented at the 39th Annual Meeting of the Turkish Society of Plastic, Reconstructive and Aesthetic Surgery; October 11, 2017; Antalya, Turkey.

Reprints: Billur Sezgin, MD, Department of Plastic Surgery, Koç University Hospital, Davutpasa cad. No. 4, Topkapi, 34010 Istanbul, Turkey. E-mail:

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.