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Measurement of Preoperative and Postoperative Nasal Tip Projection and Rotation
Koen Ingels, MD, PhD;
Kadir S. Orhan, MD
Arch Facial Plast Surg. 2006;8(6):411-415.
Objective To measure the effect of columellar struts and cephalic trim on tip projection and tip rotation using digitized photographs.
Methods Using photographs of 62 patients who underwent external rhinoplasty, we retrospectively analyzed nasal tip projection (the Goode method) and rotation (nasolabial angle) before and after surgery. A cartilaginous strut was used in 36 patients, whereas 26 patients did not receive a strut. Patients were categorized into 4 subgroups, depending on the placement of a strut (placement, strut+ vs nonplacement, strut–) and the removal of the cephalic margin (removal, cephalic+ vs nonremoval, cephalic–) of the lateral crus: strut–/cephalic–, n = 17; strut+/cephalic–, n = 23; strut–/cephalic+, n = 9; strut+/cephalic+, n = 12.
Results Nasal tip projection, measured with the Goode method, increased from 0.58 to 0.60 (P = .02) in the strut+ group; in the strut– group, nasal tip projection did not change significantly. Nasolabial angle increased from 93.96° to 100.92° in the strut+/cephalic– group and from 88.30° to 95.06° in the strut+/cephalic+ group. Removal of the cephalic margin alone (strut–/cephalic+) hardly affected tip rotation (P = .05).
Conclusions The external rhinoplasty approach did not lead to a decrease in nasal tip projection. A cartilaginous strut slightly increased nasal tip projection and also increased nasal tip rotation. This effect was accentuated by the removal of the cephalic margin of the lateral crus.
Author Affiliations: Department of Otorhinolaryngology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
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