Tip Surgery in Dorsal Preservation Rhinoplasty: The Effect of Modified Low Septal Strip Septoplasty on Tip Plasty.

BACKGROUND: The aim in tip surgery is to provide rotation, derotation, projection and deprojection. In this study, we aimed to show the effects of modified low septal strip septoplasty, septal extension graft, TIG technique and additional maneuvers on tip shape in dorsal preservation rhinoplasty (DPR) and to discuss our clinical results. PATIENTS AND METHODS: One hundred eighty-nine patients who underwent DPR with modified low septal strip septoplasty between November 2021 and August 2023 were included in the study. Demographic data, complications, revision surgeries and follow-up periods of the patients were analyzed retrospectively. RESULTS: The mean age of the patients is 29.58±9.04 (17-65). The mean follow-up period was 14, 50±2,98 months. Complications were observed in 1.1% of the patients (n=2/189). Revision surgery was performed in all these patients. Residual hump in 2 were observed and dorsum rasping was performed under local anesthesia. No tip revision was performed on any patient. CONCLUSIONS: A strong tip fixation is achieved with the modified low septal septoplasty technique described in this publication, and when combined with septal extension graft, tongue in groove technique and other suture techniques, an effective and permanent tip plasty can be performed in DPR. LEVEL OF EVIDENCE II: 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 .

Modified Diamond-Shaped Umbilicoplasty in Abdominoplasty.

BACKGROUND: The aim in umbilicoplasty is to obtain a scar that is less visible, the appropriate navel shape and depth. In our study, we aimed to achieve a more natural and younger appearance of the navel which significantly affects the aesthetic result after abdominoplasty. Modification of diamond-shaped umbilicoplasty technique and clinical results were evaluated. PATIENTS AND METHODS: Fifty-three patients were included in the study. Modified diamond-shaped umbilicoplasty was performed in 21 patients, and diamond-shaped umbilicoplasty was performed in 32 patients. Demographic data, complications, revision surgery, and follow-up periods of the patients were reviewed retrospectively. Different from the standard technique, we deepithelialized the diamond-shaped skin over the abdomen flap and designed four triangular flaps. Then, the navel was inset over these four flaps. RESULTS: Forty-six (86.8%) of the patients were females and 7 (13.2%) were males, with a mean age of 39.49 ± 9.18 years, ranging from 22 to 57 years. Complications were occurred in 9 patients in total. There was no difference between groups in complication rates. The mean VAS value of the patients in the MDSU group was 9.48 ± 0.75, it was 8.28 ± 0.99 in the DSU group, and the difference was statistically significant (p:0.001). The mean age of the MDSU group was found to be significantly higher than the DSU group (p:0.008). The BMI of the MDSU group was found to be significantly higher between two groups (p:0.009). DISCUSSION: In our study, there was no difference between the complication rates of the two techniques. Therefore, MDSU is a reliable technique. High VAS score of the patients of MDSU was statistically significant. This shows that this modification provides good aesthetic results. CONCLUSION: Modified diamond-shaped umbilicoplasty is easy to perform and provides better aesthetic results. 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 .

Modification of Low Septal Strip Septoplasty to Reduce Hump Recurrence in Dorsal Preservation Rhinoplasty.

BACKGROUND: Among the problems encountered in the dorsal preservation rhinoplasty technique are residual hump and hump recurrence. In our study we performed a modification to lower strip resection and the fixation of the septum. The clinical results of these modifications on hump recurrence were investigated. PATIENTS AND METHODS: 231 patients who underwent dorsal preservation rhinoplasty with low septal strip septoplasty between November 2021 and February 2023 were included in the study. Closed dorsal preservation rhinoplasty was performed with low septal strip septoplasty in 31.2% (n=72) and modified low septal strip septoplasty technique in 68.8% (n=159) patients. All cases were primary rhinoplasty. Demographic data, complications, revision surgeries and follow-up periods of the patients were analyzed retrospectively. RESULTS: The mean follow-up period of the cases was 9.68±4.02 (3-16) months. Gender and age of the cases did not differ statistically significantly between the groups (p>0.05). Complications were observed in 3.5% of the patients (n=8/231). The complications in the low septal strip septoplasty group were statistically significantly higher than in the modified low septal strip septoplasty group (p=0.012; p<0.05). The incidence of recurrent hump complications in the low septal strip septoplasty group was statistically significantly higher than in the modified low septal strip septoplasty group (p=0.029; p<0.05). CONCLUSIONS: Septum fixation is one of the most important parts of the surgery in dorsal preservation rhinoplasty and must be done properly. In this modification that we described, the risk of recurrent hump is reduced, as sufficient septum fixation is achieved.