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Background: Nasal tip refinement is a challenging step of East Asian rhinoplasty due to complex anatomical defects. Autologous costal cartilage grafts are commonly used to provide nasal tip support. This study aims to evaluate the efficacy and safety of a modified technique using a lollipop-like cartilage graft with a peach-shaped head. Methods: A retrospective review was conducted on Chinese patients who underwent primary rhinoplasty with the modified technique between November 2018 and March 2021 at our center. Preoperative and postoperative facial photographs, patient-reported outcome measures including the visual analog scale (VAS) and the rhinoplasty outcome evaluation (ROE), as well as surgery-related complications, were collected for outcome assessment. Results: A total of 31 adult patients were included in this retrospective cohort study, with a mean follow-up period of 17.12 ± 3.89 months. The majority of patients (28/31; 90.3%) expressed satisfaction with the aesthetic outcomes, as evidenced by a significant increase in mean VAS score from 3.97 ± 1.52 preoperatively to 7.39 ± 0.22 postoperatively (P < 0.01), and a significant increase in mean ROE score from 11.77 ± 2.33 to 17.22 ± 2.47 (P < 0.01). Photogrammetric analysis also demonstrated significant improvements in nasal anatomical measurements. Among the three patients with unsatisfactory feedback, two had mild columella deviations and one had a mild dorsum deviation. No other notable complications were reported. Conclusion: The current study supports the safety and utility of the modified technique utilizing the lollipop-like costal cartilage graft with a peach-shaped head for major tip refinement in East Asian patients. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

IntroductionThis study explores the profound impact of nasal structure on individuals' self-image and emotional well-being, emphasizing the increasing popularity of rhinoplasty in Saudi Arabia, influenced by societal beauty standards portrayed on social media. The investigation aims to unravel the complex interplay between demographic factors, such as gender and age distribution, and prevalent nasal deformities in a cohort of 293 participants.Material and methodsThis retrospective study at the University of Hail and King Khalid Hospital, Saudi Arabia, investigated nasal deformities in 293 participants aged 15–54. Ethical approval was obtained, and data, including bio-demographics and nasal deformities, were retrospectively reviewed. Statistical analyses, utilizing chi-square and Fisher exact tests, assessed associations, enhancing internal validity. The study targeted a diverse population, emphasizing ethical guidelines and systematic sampling.ResultsOur study of 293 participants revealed a prevalence of common nasal deformities. Dorsal hump deformity (59.0%) was the most prevalent, followed by external nasal deviation (54.6%). Significant gender differences were observed, with males more prone to external nasal deviation (65.6%), while decreased nasal tip rotation was more common in females (40.6%). Variations in nasal tip shape were statistically significant, with broad nasal tip shape more prevalent in females (35.2%).ConclusionIn conclusion, our study highlights the prevalence of common nasal deformities, emphasizing significant gender variations. These findings contribute to a deeper understanding of nasal anatomy, essential for informed decision-making in rhinoplasty.

Background: Control of nasal tip position is critical to final rhinoplasty outcomes. Two frequent methods of exerting tip control are columellar strut and caudal septal extension graft (SEG). Past work has demonstrated that SEG are better able to preserve tip position. However, there is no quantitative data describing long-term projection and rotation. The purpose of this study was to analyze long-term maintenance of tip projection and rotation following SEG. Methods: A retrospective study of adult patients undergoing open rhinoplasty was conducted. Three-dimensional photogrammetric evaluation of nasal tip position was performed. Anthropometric points were analyzed preoperatively and postoperatively. Outcome variables were tip projection, tip rotation, and nasal length. Results: Twenty patients were included with an average follow-up time of 3.3 years (2.0 – 6.6 years). From postoperative week 1 to 6, there was a statistically significant decrease in rotation (−4.3%, p<0.01). There were no statistically significant decreases in projection, rotation, or nasal length from 6 weeks postoperative to 2 years postoperative, or from 6 weeks postoperative to final follow-up (2.0 – 6.6 years). Conclusions: Nasal tip projection and rotation appear to decrease from the immediate postoperative position, likely due to resolving edema. In this study, patients that underwent open rhinoplasty with SEG experienced modest loss of projection and rotation until 6 weeks postoperative, but projection and rotation were maintained from 6 weeks postoperative to 2 years and beyond. This study provides evidence that SEG maintains long-term changes in tip projection and rotation. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Nasal tip surgery is an important component of rhinoplasty and it is a challenging issue including creating an ideal or aesthetical tip rotation and projection and keeping it during the long term. Columellar strut graft (CSG) and septal extension graft (SEG) are current and valid major surgical techniques that provide nasal tip support. Dom extension graft (DEG), which is a modification of SEG, aims to create a structure resistant to the forces loaded on the type supports in the long term by transferring the forces to columellar strut graft (CSG). Level of evidence: Level IV, Therapeutic study [ABSTRACT FROM AUTHOR]

Objective: To evaluate the influence of variations in the upper sulcus depth, nasal tip protrusion, and nasolabial angle on the esthetic perception of profiles. Design: A web-based survey study and was conducted in the Department of Orthodontics and Dentofacial Orthopaedics. This survey was conducted for a period of 10 months and included orthodontists practicing in India. Methods: This study included lateral cephalograms of the most esthetic profiles from a set of 30 profiles that were within Holdaways norms; the most esthetic profile was determined by a panel of two orthodontists and two general dentists. The most esthetic profile photograph will be transferred to a computer in Corel software. The outline of the profile will remain the same, with the inner aspect converted into a dark area (black); now, the profile is completely converted into facial silhouettes. This black facial silhouette is presented to avoid any distractions and bias. There will be a total of 27 silhouettes by various combinations of increased, decreased, and normal values for nasolabial angle, upper sulcus depth, and nasal tip protrusions. Results: Both the orthodontist and layman chose the most favored profile as a normal profile having a normal nasal tip, normal nasolabial angle, and normal upper sulcus depth, whereas among dentists, 50% chose the most favored profile in which the nasolabial angle was normal but the nasal tip and upper labial sulcus were decreased. When it comes to the least favored profiles, opinions varied between orthodontists, dentists, and laymen. Conclusion: The perception of facial esthetics has always been and still is varied between the layman, the dentist, and the orthodontists. Profiles with normal to sharp noses with normal and increased nasolabial angles were considered more attractive than the others. Profiles with fuller upper labial sulci were considered least attractive with other parameters changing. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the influence of variations in the upper sulcus depth, nasal tip protrusion, and nasolabial angle on the esthetic perception of profiles. Design: A web-based survey study and was conducted in the Department of Orthodontics and Dentofacial Orthopaedics. This survey was conducted for a period of 10 months and included orthodontists practicing in India. Methods: This study included lateral cephalograms of the most esthetic profiles from a set of 30 profiles that were within Holdaways norms; the most esthetic profile was determined by a panel of two orthodontists and two general dentists. The most esthetic profile photograph will be transferred to a computer in Corel software. The outline of the profile will remain the same, with the inner aspect converted into a dark area (black); now, the profile is completely converted into facial silhouettes. This black facial silhouette is presented to avoid any distractions and bias. There will be a total of 27 silhouettes by various combinations of increased, decreased, and normal values for nasolabial angle, upper sulcus depth, and nasal tip protrusions. Results: Both the orthodontist and layman chose the most favored profile as a normal profile having a normal nasal tip, normal nasolabial angle, and normal upper sulcus depth, whereas among dentists, 50% chose the most favored profile in which the nasolabial angle was normal but the nasal tip and upper labial sulcus were decreased. When it comes to the least favored profiles, opinions varied between orthodontists, dentists, and laymen. Conclusion: The perception of facial esthetics has always been and still is varied between the layman, the dentist, and the orthodontists. Profiles with normal to sharp noses with normal and increased nasolabial angles were considered more attractive than the others. Profiles with fuller upper labial sulci were considered least attractive with other parameters changing.

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A 65-year-old man presented with a Melanoma in situ of the nasal tip. Complete excision was achieved after 2 “Slow Mohs” stages, resulting in a circular 2.7 X 2.4 cm defect involving the right lateral nasal tip, dorsum and sidewall and extending to the perichondrium.

Introduction: Replacing the skin along the nasal tip remains a challenge. Depending on the extent of the skin loss, various local or regional flaps are available for reconstruction. If cutaneous replacement involves the nasal tip, the forehead flap can be used successfully. However, it requires a multistage procedure and can leave considerable scarring on the patient's forehead. As an alternative, the authors present the free style "Twin V/Y Nasal Perforator Flaps" (TVYNPF), which can be used as a one-stage procedure for nasal tip reconstruction., Material and Methods: A series of five patients aged between 69 and 89 years with extensive basal cell carcinomas at the nasal tip is presented. The surgical procedure is explained in detail. The follow-up period ranged from 8 to 12 months., Results: Healing was uneventful for all five patients, and the shape, symmetry, and aesthetical unity of the nasal tip and the alae of the nose were preserved in all patients, without any functional impairment. All scars presented inconspicuously., Conclusion: In the selected patients, the free style TVYNPF proved to be a good alternative to the forehead flap for one-stage reconstruction of significant skin loss along the nasal tip, while preserving the esthetics and function of the nose., Competing Interests: Declaration of Competing Interest There are no conflicts of interest including employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Introduction: This study explores the profound impact of nasal structure on individuals' self-image and emotional well-being, emphasizing the increasing popularity of rhinoplasty in Saudi Arabia, influenced by societal beauty standards portrayed on social media. The investigation aims to unravel the complex interplay between demographic factors, such as gender and age distribution, and prevalent nasal deformities in a cohort of 293 participants., Material and Methods: This retrospective study at the University of Hail and King Khalid Hospital, Saudi Arabia, investigated nasal deformities in 293 participants aged 15-54. Ethical approval was obtained, and data, including bio-demographics and nasal deformities, were retrospectively reviewed. Statistical analyses, utilizing chi-square and Fisher exact tests, assessed associations, enhancing internal validity. The study targeted a diverse population, emphasizing ethical guidelines and systematic sampling., Results: Our study of 293 participants revealed a prevalence of common nasal deformities. Dorsal hump deformity (59.0%) was the most prevalent, followed by external nasal deviation (54.6%). Significant gender differences were observed, with males more prone to external nasal deviation (65.6%), while decreased nasal tip rotation was more common in females (40.6%). Variations in nasal tip shape were statistically significant, with broad nasal tip shape more prevalent in females (35.2%)., Conclusion: In conclusion, our study highlights the prevalence of common nasal deformities, emphasizing significant gender variations. These findings contribute to a deeper understanding of nasal anatomy, essential for informed decision-making in rhinoplasty., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Alotaibi, Alsuwayt, Raghib, Alsayer, Albarrak, Alrasheedi, Saleem, Afreen and Friedman.)

The authors propose a novel flap for rhinoplasty: the supratip cross flap (SCF). It is a simple and effective method for avoiding and correcting alar contour deformities and external nasal valve (ENV) issues in rhinoplasty without grafts. In addition to its benefit for supratip break, the flap also allows a smooth and natural transition between the nasal dorsum and the nasal tip complex.