Key Points in Subperichondrial-Subperiosteal Dissection.

"Subperichondrial-subperiosteal dissection technique (SSDT) decreases soft tissue injury to a minimum by protecting soft tissues from dissection and retraction traumas. The fact remains that dissecting the perichondrium of the nasal tip cartilages is not effortless. Cartilages may be harmed if dissection is not initiated at the right location. The aforementioned surgeons have routinely used the SSDT between the years 2008 and 2019 in more than 4000 rhinoplasties. The number of the surgeons making use of the SSDT will increase with the understanding of the key points in dissection, their ordering, and use of correct instrumentation."

Comparison of the effects of columellar strut and septal extension grafts for tip support in rhinoplasty.

BACKGROUND: The purpose of this study was to compare the effects of columellar strut and septal extension grafts for reconstruction of caudal nasal supportive structures on the long-term stability of nasal projection and rotation. METHODS: A comparison was done on the differences between the early- and long-term results of the ratios of nasal projection to nasal length and columella labial angle values in 36 patients who were operated on by the same surgeon using columellar or septal extension grafts. RESULTS: Both grafts had the effect of increasing nasal projection, and this effect was found to be stable over time. Some increased values of nasal projection obtained in the early postoperative period were lost over time. Although no significant difference was found between the groups, clinical and numerical observations showed that the values decreased less in the group that received septal extension grafts. CONCLUSION: The tip position was more stable in cases with septal extension grafts than in those with columellar strut grafts. 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 .