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. 2018 Jul 1;20(4):292-299.
doi: 10.1001/jamafacial.2017.2450.

Association of Nasal Tip Rotation Outcome Estimation With the New Domes Technique in Primary Rhinoplasty

Fernando Pedroza  1   2 , Edgar Eduardo Santos  3 , Federico Espinosa  3 , Claudia José Velásquez  3 , Andrés Fernando Gutiérrez  3 , Enrique Fernando Serrano-Cruz  3
Affiliations

Association of Nasal Tip Rotation Outcome Estimation With the New Domes Technique in Primary Rhinoplasty

Fernando Pedroza et al. JAMA Facial Plast Surg. .

Erratum in

  • Missing Video and Citation.
    [No authors listed] [No authors listed] JAMA Facial Plast Surg. 2018 Jul 1;20(4):340. doi: 10.1001/jamafacial.2018.0589. JAMA Facial Plast Surg. 2018. PMID: 29800230 Free PMC article. No abstract available.

Abstract

Importance: The postoperative changes in the rotation of the nasal tip in rhinoplasty must be estimated for the surgical planning.

Objective: To determine whether the outcome in the rotation angle of the nasal tip can be estimated in patients undergoing primary rhinoplasty with the new domes technique.

Design, setting, and participants: This retrospective analytic cohort study included 323 patients undergoing primary rhinoplasty with the new domes technique in a private clinic in Bogotá, Colombia, by a single surgeon from January 1, 2011, through January 31, 2016. Patients undergoing secondary rhinoplasty and those with less than 6 months of follow-up were excluded.

Exposures: Primary rhinoplasty using the new domes technique.

Main outcomes and measures: Measurement of the rotation angle of the nasal tip before and 1 week and 6 months after surgery. The main variable taken into consideration was the measurement, in millimeters, of the lateralized nasal domes.

Results: A total of 323 patients (288 women [89.2%] and 35 men [10.8%]; mean age, 27.8 years; age range, 13-70 years) were included in the study. The mean (SD) preoperative nasolabial angle was 92.7° (4.4°; range, 77°-107°); at 1 postoperative week, 105.5° (4.9°; range, 92°-120°); and at 6 postoperative months, 102.1° (4.6°; range, 90°-115°). The mean (SD) increase of the rotation that was achieved per lateralized millimeter was 3.6° (2.0°). The mean (SD) rotation angle at 6 months decreased to 3.4° (2.4°).

Conclusions and relevance: The new domes technique was reliable and reproducible in most patients. Despite the unpredictable inflammatory changes, the exact lateralization in millimeters with the new domes technique allowed precise estimation of the long-term outcome of the rotation of the nasal tip, enabling the surgeon to determine from the preoperative plan the definitive rotation angle of the nose.

Level of evidence: 4.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure 1.
Figure 1.. Representative Patients Undergoing the New Domes Technique With and Without the Banner Technique
Figure 2.
Figure 2.. Example of the New Domes Technique
Figure 3.
Figure 3.. Graphic Representation of the New Domes Technique
A, Marking of the new domes with conservative cephalic excision of the lower lateral cartilage without extending to the lateral half. B, Transdomal sutures (2 mm from the new domes) create more lateral and narrowed domes. C, An intercrural strut is made and sutured in place. D, The interdomal sutures achieve the aesthetic triangle.
Figure 4.
Figure 4.. Example of the Banner Technique
Figure 5.
Figure 5.. Representative Preoperative and Postoperative Photographs of the New Domes Technique With and Without Banner Technique
All postoperative photographs were taken 6 months after surgery.
See this image and copyright information in PMC

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