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Dorsal Aesthetic Lines in Rhinoplasty: A Quantitative Outcome-Based Assessment of the Component Dorsal Reduction Technique

Mojallal, Ali M.D., Ph.D.; Ouyang, Da M.D.; Saint-Cyr, Michel M.D.; Bui, Nam M.D.; Brown, Spencer A. Ph.D.; Rohrich, Rod J. M.D.

Plastic and Reconstructive Surgery: July 2011 - Volume 128 - Issue 1 - p 280-288
doi: 10.1097/PRS.0b013e318218fc2d
Cosmetic: Original Articles

Background: Preservation or reconstruction of the middle nasal vault structure and internal nasal valve after dorsal reduction is challenging. The purpose of this study was to retrospectively analyze a series of 100 consecutive rhinoplasty cases with respect to preservation or restoration of the dorsal nasal lines following component dorsal reduction. A new quantitative mathematical application for subject digital images was performed.

Methods: Medical information and digital images were obtained from 100 consecutive primary rhinoplasty patients from one author (R.J.R.) with University of Texas Southwestern Medical Center Institutional Review Board consent. All postoperative subject digital images were taken at more than 1-year follow-up. Preoperative and postoperative digital images of the dorsal nasal aesthetic lines were analyzed using a software application that quantitated various facial anatomical features compared with landmark measurements unique for each subject (pupil-to-pupil distance). Dorsal line symmetry, nose width, and variation of deformities on each side of the face were determined.

Results: Mean subject dorsal line symmetry was 68 percent preoperatively and 94 percent postoperatively. Only 32.5 percent of dorsal lines were harmonious preoperatively, whereas 97 percent of dorsal lines were harmonious postoperatively. Identification of dorsal lines postoperatively versus preoperatively was similar in 74.6 percent, improved in 15.7 percent, and decreased in 9.7 percent. Nasal width lines were similar in 36 subjects, 21 subjects had wider nasal width lines, and 43 subjects had narrower width lines after surgery.

Conclusions: Component dorsal hump reduction procedures result in reliable and reproducible clinical outcomes. Quantitative assessments provide evidence that improved and harmonious curves of dorsal aesthetic lines are achievable.




Lyon, France; and Dallas, Texas

From the Department of Plastic, Aesthetic, and Reconstructive Surgery, Edouard Herriot Hospital, and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication March 18, 2009; accepted September 15, 2009.

Presented at the 53rd Annual Congress of the French Society of Aesthetic Plastic and Reconstructive Surgery (SoFCPRE), in Paris, France, November 24 through 26, 2008.

Disclosure: The authors have no financial interest in this research project or in any of the techniques or equipment used in this study. The authors have no conflicts of interest to disclose.

Ali Mojallal, M.D., Department of Plastic Aesthetic and Reconstructive Surgery, University of Lyon, Edouard Herriot Hospital, Place d'Arsonval, 69437 Lyon, Cedex 03, France,

©2011American Society of Plastic Surgeons