1
|
Jin C, Wu Q, Yin A, Chen J, Liu H, Mu S, Zhang X. Lollipop-Like Costal Cartilage Graft with a Peach-Shaped Head for East Asian Rhinoplasty. Aesthetic Plast Surg 2024; 48:2404-2411. [PMID: 38233685 DOI: 10.1007/s00266-023-03799-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/04/2023] [Indexed: 01/19/2024]
Abstract
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 .
Collapse
Affiliation(s)
- Changxin Jin
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Air Force Medical University, Changle West Road, No. 169, Xi'an, 710032, Shaanxi, China
| | - Qiong Wu
- Department of Medical cosmetology, The First Hospital of Xi'an, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi, Key Laboratory of Resource Biology and Modern Biotechnology in Western China, Faculty of Life Science, Northwest University, Xi'an, 710032, Shaanxi, China
| | - Anan Yin
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Air Force Medical University, Changle West Road, No. 169, Xi'an, 710032, Shaanxi, China.
| | - Jie Chen
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Air Force Medical University, Changle West Road, No. 169, Xi'an, 710032, Shaanxi, China
| | - Hengxin Liu
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Air Force Medical University, Changle West Road, No. 169, Xi'an, 710032, Shaanxi, China
| | - Siqi Mu
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Air Force Medical University, Changle West Road, No. 169, Xi'an, 710032, Shaanxi, China
| | - Xi Zhang
- Department of Plastic and Reconstructive Surgery, Xijing Hospital, Air Force Medical University, Changle West Road, No. 169, Xi'an, 710032, Shaanxi, China.
| |
Collapse
|
2
|
Tiftikcioglu YO, Yegin EE, Yegin ME, Topaloglu E, Canbolat OC, Gur E, Ceylan N. Development of an Algorithm to Determine Which Costal Cartilage to Harvest. J Craniofac Surg 2024; 35:1134-1137. [PMID: 38738902 DOI: 10.1097/scs.0000000000010101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/22/2024] [Indexed: 05/14/2024] Open
Abstract
Rib graft is a common source of cartilage in rhinoplasty. Donor site choices for this resource were identified according to the authors who presented the introduction of this technique. However, the scientific basis of this valuable method lacks information, including the anatomical properties of costal cartilage. In this study, cartilage radioanatomy is examined and tested for if any estimators are present. A total of 148 thoracal CT scans of patients who applied to our facility were analyzed. Patients were divided per their sex and age of 35, and rib cartilage dimensions, including axial length between the sternal and costal ends of the cartilage (TotL), posteroanterior diameters at the sternal end (StDia), costal end (CosDia), the thickest part (MaxDia) as diametrical parameters and vertical height at the thickest part (h) were recorded. Length of the sternum (St), the axial length of the clavicle (ClavL), the distance of the sixth rib from the anterior axillary border (AntAx), and thorax circumferences at the level of both pectoralis major muscle origin (ThC) and nipples (BrC) were recorded. Statistical analyses were done for correlations. St, ClavL, ThC, and BrC were found to have the most correlated measurements in groups with the age of 35 and less of both genders, and the relations were lost in older groups. Thorax shape may change after the age of 35 years, but in younger patients, St in females and ClavL in males can be used as estimators of cartilage amount.
Collapse
Affiliation(s)
- Yigit O Tiftikcioglu
- Plastic, Reconstructive and Aesthetic Surgery Department, Ege University Faculty of Medicine, Izmir
| | - Ecem E Yegin
- Bioinformatics Department, Istinye University Faculty of Science
| | - M Emre Yegin
- Plastic, Reconstructive and Aesthetic Surgery Department, Istinye University Faculty of Medicine
| | - Ege Topaloglu
- Plastic, Reconstructive and Aesthetic Surgery Department, Ege University Faculty of Medicine, Izmir
| | - Ozan C Canbolat
- Plastic, Reconstructive and Aesthetic Surgery Department, Bakirkoy Sadi Konuk Trainşng and Research Hospital, Istanbul
| | | | - Naim Ceylan
- Department of Radiodiagnostics, Ege University Faculty of Medicine, Izmir, Turkey
| |
Collapse
|
3
|
Lin Y, Chen B, Zhu X, Ma Y, Liu J, Wang M, Chen X. "An integrated clip-shaped costal cartilage carving approach for rhinoplasty". J Plast Reconstr Aesthet Surg 2022; 75:2796-2801. [PMID: 35562289 DOI: 10.1016/j.bjps.2022.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/25/2022] [Accepted: 04/12/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nasal tip management is considered to be one of the most complicated and challenging parts of rhinoplasty in East Asian patients. Within current rhinoplasty surgical practice, costal cartilage serves as an ideal source for grafting due to its ability to provide strong support to the nasal tip. METHODS From March 2013 to December 2021, integrated clip-shaped costal cartilage grafts were applied to patients with primary (n = 12) or secondary (n = 3) short nose deformities. The costal cartilage was carved into an monobloc clip-shaped cartilage graft and then placed on the nasal septum and fixed with sutures. The nasal length index, projection index, and nasolabial angles were measured preoperatively and postoperatively. Postoperative evaluation at 8 months was performed using a grading scale. RESULTS A total of 15 patients were included in this study with an average age of 23.7 ± 3.6 years. The mean follow-up period was 14.3 ± 5.3 months and ranged from 8 to 26 months. There were statistically significant differences between the preoperative and postoperative values in nose length index and projection index. Also, the nasolabial angle was significantly reduced. Postoperative evaluation, conducted at a minimum of 8 months following surgery, showed that 86.6% (13/15) of patients felt that their surgical results were good or excellent. No patients rated the results as "poor". CONCLUSION The integrated clip-shaped costal cartilage carving approach has been shown to be a practical method of obtaining satisfactory esthetic outcomes in patients with nasal deformities.
Collapse
Affiliation(s)
- Yanyan Lin
- Department of Plastics and Cosmetic, The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Road, Wenzhou 325000, China
| | - Ben Chen
- Department of Plastics and Cosmetic, The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Road, Wenzhou 325000, China
| | - Xiuying Zhu
- Department of Plastics and Cosmetic, The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Road, Wenzhou 325000, China
| | - Yingjie Ma
- Department of Plastics and Cosmetic, The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Road, Wenzhou 325000, China
| | - Jia Liu
- Department of Plastics and Cosmetic, The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Road, Wenzhou 325000, China
| | - Min Wang
- Department of Plastics and Cosmetic, The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Road, Wenzhou 325000, China
| | - Xi Chen
- Department of Plastics and Cosmetic, The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Road, Wenzhou 325000, China.
| |
Collapse
|
4
|
Halepas S, Lee KC, Castiglione C, Ferneini EM. Grafting in Modern Rhinoplasty. Oral Maxillofac Surg Clin North Am 2020; 33:61-69. [PMID: 33153889 DOI: 10.1016/j.coms.2020.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Rhinoplasty is considered one of the most technically difficult surgical procedures because of the limited access and requirement for three-dimensional visual perception and manipulation. Grafting is an essential part of primary and secondary rhinoplasties and forms the foundation for a successful functional and aesthetic outcome. Septal cartilage is the most commonly used grafting material, although many reliable alternatives exist. No randomized clinical trials have been conducted comparing graft materials and techniques for specific indications. In this review, the authors discuss the most common grafting materials and configurations used in the modern rhinoplasty.
Collapse
Affiliation(s)
- Steven Halepas
- Division of Oral & Maxillofacial Surgery, Columbia University Medical Center, New York-Presbyterian, 622West 168th Street, Suite 7-250, New York, NY 10032, USA
| | - Kevin C Lee
- Division of Oral & Maxillofacial Surgery, Columbia University Medical Center, New York-Presbyterian, 622West 168th Street, Suite 7-250, New York, NY 10032, USA
| | - Charles Castiglione
- Division of Plastic Surgery, Hartford Hospital and Connecticut Children's Medical Center, University of Connecticut School of Medicine, 399 Farmington Avenue, Suite 210, Farmington, CT 06032, USA
| | - Elie M Ferneini
- Beau Visage Med Spa, Cheshire, CT, USA; Department of Surgery, Frank H Netter MD School of Medicine, Quinnipiac University, Hamden, CT, USA; Division of Oral & Maxillofacial Surgery, University of Connecticut, Farmington, CT, USA.
| |
Collapse
|