Abstract
A novel technique is presented for columellar reconstruction via the sublabial approach, which is a challenging endeavor, both functionally and aesthetically. Patients with columellar collapse underwent columellar reconstruction via the sublabial approach. Following an upper gingivobuccal sulcus incision, a tunnel was created through which a cartilage graft, preferably septal, was introduced and fixed. An additional crescent-shaped graft was introduced to secure the fixed graft into position. Average operating time was 35 min for septal grafts and 55 min for conchal grafts. Postoperative complications were minimal. This approach is an anatomic, minimally invasive, time-saving procedure. The technique is easy to perform and can be rapidly mastered. It provides strong structural support, shape, height, and projection to the tip lobule via an inconspicuous scar. It is particularly advantageous in cases of previous septal operations and septal perforation and can be performed as a prophylactic measure in cases of poor tip support and when the anterior septum is severely deformed.
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References
Bilkay U, Tokat C, Ozek C, Erdem O, Cagdas A (2004) Reconstruction of congenital absent columella. J Craniofac Surg 15(1):60–63
Perkins SW, Dayan SH (2002) Management of nasal trauma. Aesthetic Plast Surg 26(Suppl 1):S3
Cronin TD, Upton J (1978) Lengthening of the short columella associated with bilateral cleft lip. Ann Plast Surg 1(1):75–95
Cohen S, Ad-El D, Yaniv E, Billig A, Tov JS (2009) Sublabial approach for columellar reconstruction in corrective rhinoplasty. J Plast Reconstr Aesthet Surg 62(11):1446–1452
Margulis A, Bauer BS, Han H, Patel PK (2003) Reconstruction of the columellar in a pediatric patient. Plast Reconstr Surg 112(7):1948–1949
Byrd HS, Hobar PC (1993) Rhinoplasty. Selected reading in plastic surgery. Plast Reconstr Surg 91(4):642–654
Rohrich RJ, Muzaffar AR (2000) Primary rhinoplasty. In: Achauer BM, Eriksson E, Guyuron B, Coleman JJ III, Russel RC, Vander Kolk CA (eds) Plastic surgery indication, operations and outcomes, 1st edn. Mosby, St. Louis, pp 2631–2671
Sheen JH (1987) Esthetic rhinoplasty, vols I and II, 2nd ed. Mosby, St. Louis
Gunter JP (1995) Facial analysis for the rhinoplasty patient. In: The tenth dallas rhinoplasty symposium, Dallas, 1995, pp 17–28
Gunter JP (1993) The importance of alar-columellar relationship in rhinoplasty. In: The tenth dallas rhinoplasty symposium, Dallas, 1993, pp 37–46
Sheen JH (1993) Tip graft: a 20-year retrospective. Plast Reconstr Surg 91(1):48–63
Peck GC (1983) The onlay tip graft for nasal tip projection. Plast Reconstr Surg 71(1):27–39
Rohrich RJ (1998) An 18-year experience with the umbrella graft in rhinoplasty (discussion). Plast Reconstr Surg 102(6):2166–2168
Gruber RP, Grover S (1999) The anatomic tip graft for nasal augmentation. Plast Reconstr Surg 103(6):1744–17453
Constantian MB (1999) The anatomic tip graft for nasal augmentation (techniques in cosmetic surgery). Plast Reconstr Surg 103(6):1754–1758
Menick FJ (1999) Anatomic reconstruction of the nasal tip cartilages in secondary reconstructive rhinoplasty (cosmetic). Plast Reconstr Surg 104(7):2187–2198
Rohrich RD, Muzaffar AR (2006) Primary rhinoplasty. In: Mathes SJ (ed) Plastic surgery, 2nd edn. WB Saunders, Philadelphia, pp 427–471
Constantian MB (2006) Closed rhinoplasty: current technique, theory, and applications. In: Mathes SJ (ed) Plastic surgery, 2nd edn. WB Saunders, Philadelphia, pp 517–572
Rohrich RJ, Huynh B, Muzaffar AR, Adams WP Jr, Robinson JB Jr (2000) Importance of the depressor septi nasi muscle in rhinoplasty: anatomic study and clinical application. Plast Reconstr Surg 105(1):376–383
Cachay-Velasquez H (1992) Rhinoplasty and facial expression. Ann Plast Surg 28(5):427–433
Lawson W, Reino AJ (1995) Reduction columelloplasty. A new method in the management of the nasal base. Arch Otolaryngol Head Neck Surg 121(10):1086–1088
Cetinkale O, Tulunay S (1998) Augmentation of the columella-labial angle to prevent the “smiling deformity” in rhinoplasty. Aesthetic Plast Surg 22(2):106–110
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Cohen, S., Tov, J.S. (2013). Sublabial Approach for Columellar Reconstruction in Corrective Rhinoplasty. In: Shiffman, M., Di Giuseppe, A. (eds) Advanced Aesthetic Rhinoplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28053-5_41
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DOI: https://doi.org/10.1007/978-3-642-28053-5_41
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