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Transection of Pitanguy’s Midline Ligament to Avoid Supratip Depression in Closed-Approach Low-Septal-Resection Dorsal Preservation Rhinoplasty

Aesthet Surg J. 2022 Jul 31:sjac211. doi: 10.1093/asj/sjac211. Online ahead of print.


BACKGROUND: Supratip depression is a common complication after preservation rhinoplasty.

OBJECTIVES: This paper presents a simple surgical maneuver to prevent supratip depression.

METHODS: Thirty-six patients who underwent closed-approach low-septal-resection dorsal preservation rhinoplasty between January and June 2021 were included in this retrospective study. Depending on the operation performed on Pitanguy’s midline ligament, the patients were divided into two main groups as follows: (1) a group in which Pitanguy’s midline ligament was transected (the transection group), and (2) a group in which Pitanguy’s midline ligament was preserved (the preservation group). Standardized postoperative 6-month lateral-view photographs were scanned for the presence of supratip depression or pollybeak deformity. The Rhinoplasty Outcome Evaluation (ROE) scale was applied at 6 months.

RESULTS: Supratip depression was observed in four patients in the preservation group (n = 16), and it was not observed in any of the patients in the transection group (n = 20; p < 0.05). There was no pollybeak deformity in either group. For the ROE scores and number of satisfied patients, no statistically significant difference was found between the groups with Pitanguy’s midline ligament transected versus preserved (p > 0.05).

CONCLUSIONS: Transecting Pitanguy’s midline ligament reduces the likelihood of supratip depression and does not affect the likelihood of pollybeak deformity in closed-approach low-septal-resection dorsal preservation rhinoplasty.

PMID:35908175 | DOI:10.1093/asj/sjac211

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