Strategic Use of the V-Shaped Columella- Labial Incision for Reconstructive Rhinoplasty in Severely Compromised Noses.

IF 3 2区医学 Q1 SURGERY

Aesthetic Surgery Journal Pub Date : 2025-05-23 DOI:10.1093/asj/sjaf060

Amir A Sazgar, Mehr A Sazgar, Rojan Zarei, Amir K Sazgar

{"title":"Strategic Use of the V-Shaped Columella- Labial Incision for Reconstructive Rhinoplasty in Severely Compromised Noses.","authors":"Amir A Sazgar, Mehr A Sazgar, Rojan Zarei, Amir K Sazgar","doi":"10.1093/asj/sjaf060","DOIUrl":null,"url":null,"abstract":"Background: Columellar incision techniques for multiply operated and/or severely compromised noses are critical in reconstructive rhinoplasty, because they impact both the final outcome and the risk of complications, such as wound dehiscence and skin flap necrosis.Objectives: The aims of the study are to evaluate the safety of the columella-labial incision in patients with previous mid-columellar scars and assess the functional and aesthetic outcomes of reconstructive septorhinoplasty using this strategic incision through patient-reported outcome measures and chart reviews.Methods: This case series included patients with previous unsuccessful rhinoplasties and mid-columellar scars who underwent open-approach reconstructive septorhinoplasty with a columella-labial incision. Collected data included demographics, medical history, operative reports, and postoperative events. Skeletal reconstruction was performed using various autografts. The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) was administered preoperatively and 1 year postoperatively.Results: Most patients were female (68/91, 75%), with a mean age of 37.6 years and 1.74 previous rhinoplasties. The average surgery duration was 239.5 min. Autografts included auricular cartilage (64), costal cartilage (43), temporal fascia (12), and rectus fascia (24). No cases of dehiscence or vascular complications occurred, even in patients with multiple previous mid-columellar incisions. SCHNOS scores significantly improved, with obstruction scores decreasing from 52.86 to 18.43 (standard deviation [SD] = 8.33 vs 3.95) and cosmesis scores from 78.09 to 20.19 (SD = 6.44 vs 5.13).Conclusions: The V-shaped columella-labial incision does not increase the risk of vascular compromise, even in patients with mid-columellar scars. Its strategic use facilitates skeletal reconstruction while effectively improving nasal contour and columellar length with acceptable scarring.Level of evidence: 4 (therapeutic): ","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aesthetic Surgery Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/asj/sjaf060","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Columellar incision techniques for multiply operated and/or severely compromised noses are critical in reconstructive rhinoplasty, because they impact both the final outcome and the risk of complications, such as wound dehiscence and skin flap necrosis.

Objectives: The aims of the study are to evaluate the safety of the columella-labial incision in patients with previous mid-columellar scars and assess the functional and aesthetic outcomes of reconstructive septorhinoplasty using this strategic incision through patient-reported outcome measures and chart reviews.

Methods: This case series included patients with previous unsuccessful rhinoplasties and mid-columellar scars who underwent open-approach reconstructive septorhinoplasty with a columella-labial incision. Collected data included demographics, medical history, operative reports, and postoperative events. Skeletal reconstruction was performed using various autografts. The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) was administered preoperatively and 1 year postoperatively.

Results: Most patients were female (68/91, 75%), with a mean age of 37.6 years and 1.74 previous rhinoplasties. The average surgery duration was 239.5 min. Autografts included auricular cartilage (64), costal cartilage (43), temporal fascia (12), and rectus fascia (24). No cases of dehiscence or vascular complications occurred, even in patients with multiple previous mid-columellar incisions. SCHNOS scores significantly improved, with obstruction scores decreasing from 52.86 to 18.43 (standard deviation [SD] = 8.33 vs 3.95) and cosmesis scores from 78.09 to 20.19 (SD = 6.44 vs 5.13).

Conclusions: The V-shaped columella-labial incision does not increase the risk of vascular compromise, even in patients with mid-columellar scars. Its strategic use facilitates skeletal reconstruction while effectively improving nasal contour and columellar length with acceptable scarring.

Level of evidence: 4 (therapeutic):

查看原文本刊更多论文

v型鼻小柱唇切口在重度鼻部再造术中的策略性应用。

背景：小柱切口技术对于多次手术和/或严重受损的鼻子是重建鼻成形术的关键，因为它们既影响最终结果，也影响并发症的风险，如伤口开裂和皮瓣坏死。目的：本研究的目的是通过患者报告的结果测量和图表回顾来评估先前有中小柱疤痕的患者使用小柱-唇切口的安全性，并评估使用该策略切口的鼻中隔成形术的功能和美学结果。方法：本病例系列包括先前鼻整形失败和中鼻小柱疤痕的患者，他们接受了开放入路鼻中隔重建成形术，并进行了鼻小柱-唇切口。收集的数据包括人口统计、病史、手术报告和术后事件。使用各种自体移植物进行骨骼重建。术前和术后1年进行标准化美容和健康鼻部结果调查（SCHNOS）。结果：大多数患者为女性（68/91,75%），平均年龄37.6岁，既往鼻整形1.74例。平均手术时间239.5 min。自体移植物包括耳软骨（64例）、肋软骨（43例）、颞筋膜（12例）和腹直筋膜（24例）。即使在先前有多个中柱切口的患者中，也没有发生裂口或血管并发症。SCHNOS评分明显提高，其中梗阻评分从52.86分降至18.43分（标准差[SD] = 8.33 vs 3.95），美容评分从78.09分降至20.19分（SD = 6.44 vs 5.13）。结论：v型小柱唇切口不会增加血管损伤的风险，即使在中小柱瘢痕患者中也是如此。它的战略性使用促进了骨骼重建，同时有效地改善了鼻轮廓和小柱长度，并留下了可接受的疤痕。证据等级：4（治疗性）：

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Aesthetic Surgery Journal SURGERY-

CiteScore

6.20

自引率

20.70%

发文量

309

审稿时长

6-12 weeks

期刊介绍： Aesthetic Surgery Journal is a peer-reviewed international journal focusing on scientific developments and clinical techniques in aesthetic surgery. The official publication of The Aesthetic Society, ASJ is also the official English-language journal of many major international societies of plastic, aesthetic and reconstructive surgery representing South America, Central America, Europe, Asia, and the Middle East. It is also the official journal of the British Association of Aesthetic Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery and The Rhinoplasty Society.