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Published in: Aesthetic Plastic Surgery 3/2015

01-06-2015 | Original Article

Effect of the Depressor Septi Nasi Muscle Modification on Nasal Tip Rotation and Projection

Authors: Javad S. Toutounchi, Sogol H. Biroon, Samira M. Banaem, Neghisa S. Toutounchi, Nariman Nezami, Behzad Salari

Published in: Aesthetic Plastic Surgery | Issue 3/2015

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Abstract

Background

The nasal tip is an important esthetic feature of the face and surgery on it is the most challenging part of a rhinoplasty. In the present study, we evaluated the effects of modification of the depressor septi nasi muscle on nasal tip rotation and projection.

Methods

Eighty primary rhinoplasty patients who required nasal tip modifications were enrolled in a randomized clinical trial from October 2008 to March 2012. A study group composed of 40 patients underwent rhinoplasty including cutting and repositioning of the depressor septi nasi muscle and another group of 40 patients (control) underwent rhinoplasty without manipulation of the depressor septi nasi muscle. Nasal tip rotation and projection, and patient satisfaction were evaluated before and 6 months after the operation.

Results

Following rhinoplasty including cutting of the depressor septi nasi muscle, nasal tip rotation and projection, and patient satisfaction were improved in 70, 57.5, and 85 % of the patients, respectively; and in the control group, they were improved in 82.5, 55, and 67.5 %, respectively (P = 0.089, 0.607, and 0.069).

Conclusion

Cutting and repositioning of the depressor septi nasi muscle as an adjunct to rhinoplasty is not associated with any additional advantage in terms of nasal tip rotation and projection, or patient satisfaction.

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.
Literature
1.
2.
go back to reference Pearlman SJ (2006) Surgical treatment of the nasolabial angle in balanced rhinoplasty. Facial Plast Surg 22(1):28–35CrossRefPubMed Pearlman SJ (2006) Surgical treatment of the nasolabial angle in balanced rhinoplasty. Facial Plast Surg 22(1):28–35CrossRefPubMed
3.
go back to reference Tebbetts JB (1994) Shaping and positioning the nasal tip without structural disruption: a new, systematic approach. Plast Reconstr Surg 94(1):61–77CrossRefPubMed Tebbetts JB (1994) Shaping and positioning the nasal tip without structural disruption: a new, systematic approach. Plast Reconstr Surg 94(1):61–77CrossRefPubMed
4.
go back to reference Rees TD (1994) The lip-tip-columella complex and the alar base. In: Rees TD, LaTrenta G (eds) Aesthetic plastic surgery. Saunders, Philadelphia Rees TD (1994) The lip-tip-columella complex and the alar base. In: Rees TD, LaTrenta G (eds) Aesthetic plastic surgery. Saunders, Philadelphia
5.
go back to reference De Souza Pinto EB, Da Rocha RP, Filho WQ et al (1998) Anatomy of the median part of the septum depressor muscle in aesthetic surgery. Aesthetic Plast Surg 22(2):111–115CrossRefPubMed De Souza Pinto EB, Da Rocha RP, Filho WQ et al (1998) Anatomy of the median part of the septum depressor muscle in aesthetic surgery. Aesthetic Plast Surg 22(2):111–115CrossRefPubMed
6.
go back to reference Rohrich RJ, Huynh B, Muzaffar AR et al (2000) Importance of the depressor septi nasi muscle in rhinoplasty: anatomic study and clinical application. Plast Reconstr Surg 105(1):376–383 discussion 84-8CrossRefPubMed Rohrich RJ, Huynh B, Muzaffar AR et al (2000) Importance of the depressor septi nasi muscle in rhinoplasty: anatomic study and clinical application. Plast Reconstr Surg 105(1):376–383 discussion 84-8CrossRefPubMed
7.
go back to reference Sajjadian A, Guyuron B (2009) An algorithm for treatment of the drooping nose. Aesthet Surg J 29(3):199–206CrossRefPubMed Sajjadian A, Guyuron B (2009) An algorithm for treatment of the drooping nose. Aesthet Surg J 29(3):199–206CrossRefPubMed
8.
go back to reference Sinno S, Chang JB, Chaudhry A et al (2014) The role of depressor septi nasi manipulation in rhinoplasty: a systematic review. Plast Reconstr Surg 134(4 Suppl 1):134–135CrossRefPubMed Sinno S, Chang JB, Chaudhry A et al (2014) The role of depressor septi nasi manipulation in rhinoplasty: a systematic review. Plast Reconstr Surg 134(4 Suppl 1):134–135CrossRefPubMed
9.
go back to reference Mahe E, Camblin J (1975) Resection of the depressor muscle of the tip in esthetic rhinoplasties. Ann Otolaryngol Chir Cervicofac 92(7–8):381–387PubMed Mahe E, Camblin J (1975) Resection of the depressor muscle of the tip in esthetic rhinoplasties. Ann Otolaryngol Chir Cervicofac 92(7–8):381–387PubMed
10.
11.
go back to reference Cachay-Velasquez H, Laguinge RE (1989) Aesthetic treatment of the columella. Ann Plast Surg 22(5):370–379CrossRefPubMed Cachay-Velasquez H, Laguinge RE (1989) Aesthetic treatment of the columella. Ann Plast Surg 22(5):370–379CrossRefPubMed
12.
go back to reference Lawson W, Reino AJ (1995) Reduction columelloplasty. A new method in the management of the nasal base. Arch Otolaryngol Head Neck Surg 121(10):1086–1088CrossRefPubMed Lawson W, Reino AJ (1995) Reduction columelloplasty. A new method in the management of the nasal base. Arch Otolaryngol Head Neck Surg 121(10):1086–1088CrossRefPubMed
13.
go back to reference de Souza Pinto EB (2003) Relationship between tip nasal muscles and the short upper lip. Aesthetic Plast Surg 27(5):381–387CrossRefPubMed de Souza Pinto EB (2003) Relationship between tip nasal muscles and the short upper lip. Aesthetic Plast Surg 27(5):381–387CrossRefPubMed
14.
go back to reference Hwang K, Kim DJ, Hwang G (2006) Relationship between depressor septi nasi muscle and dermocartilagenous ligament; anatomic study and clinical application. J Craniofac Surg 17(2):286–290CrossRefPubMed Hwang K, Kim DJ, Hwang G (2006) Relationship between depressor septi nasi muscle and dermocartilagenous ligament; anatomic study and clinical application. J Craniofac Surg 17(2):286–290CrossRefPubMed
15.
go back to reference Benlier E, Top H, Aygit AC (2005) A new approach to smiling deformity: cutting of the superior part of the orbicularis oris. Aesthetic Plast Surg 29(5):373–377 discussion 8CrossRefPubMed Benlier E, Top H, Aygit AC (2005) A new approach to smiling deformity: cutting of the superior part of the orbicularis oris. Aesthetic Plast Surg 29(5):373–377 discussion 8CrossRefPubMed
16.
go back to reference Ducut EG, Han SK, Kim SB et al (2006) Factors affecting nostril shape in Asian noses. Plast Reconstr Surg 118(7):1613–1621 discussion 22-3CrossRefPubMed Ducut EG, Han SK, Kim SB et al (2006) Factors affecting nostril shape in Asian noses. Plast Reconstr Surg 118(7):1613–1621 discussion 22-3CrossRefPubMed
17.
go back to reference Oh SH, Choi S, Kim DW et al (2012) Intranasal approach for manipulating the depressor septi nasi. J Craniofac Surg 23(2):367–369CrossRefPubMed Oh SH, Choi S, Kim DW et al (2012) Intranasal approach for manipulating the depressor septi nasi. J Craniofac Surg 23(2):367–369CrossRefPubMed
18.
go back to reference Tebbetts JB (1999) Rethinking the logic and techniques of primary tip rhinoplasty: a perspective of the evolution of surgery of the nasal tip. Otolaryngol Clin North Am 32(4):741–754CrossRefPubMed Tebbetts JB (1999) Rethinking the logic and techniques of primary tip rhinoplasty: a perspective of the evolution of surgery of the nasal tip. Otolaryngol Clin North Am 32(4):741–754CrossRefPubMed
19.
go back to reference Salari B, Totonchi JS (2011) Evaluation of the Goldman tip procedure and suture technique in tip rhinoplasty. J Plast Reconstr Aesthet Surg 64(4):467–471CrossRefPubMed Salari B, Totonchi JS (2011) Evaluation of the Goldman tip procedure and suture technique in tip rhinoplasty. J Plast Reconstr Aesthet Surg 64(4):467–471CrossRefPubMed
20.
go back to reference Goode RL (1984) A method of tip projection measurement. In: Powell N, Humphrey B (eds) Proportions of the aesthetic face. Thieme, New York Goode RL (1984) A method of tip projection measurement. In: Powell N, Humphrey B (eds) Proportions of the aesthetic face. Thieme, New York
21.
go back to reference Byrd HS, Hobar PC (1993) Rhinoplasty: a practical guide for surgical planning. Plast Reconstr Surg 91(4):642–654CrossRefPubMed Byrd HS, Hobar PC (1993) Rhinoplasty: a practical guide for surgical planning. Plast Reconstr Surg 91(4):642–654CrossRefPubMed
22.
go back to reference Ham KS, Chung SC, Lee SH (1983) Complications of oriental augmentation rhinoplasty. Ann Acad Med Singapore 12(2 Suppl):460–462PubMed Ham KS, Chung SC, Lee SH (1983) Complications of oriental augmentation rhinoplasty. Ann Acad Med Singapore 12(2 Suppl):460–462PubMed
23.
go back to reference Daniel RK, Glasz T, Molnar G et al (2013) The lower nasal base: an anatomical study. Aesthet Surg J 33(2):222–232CrossRefPubMed Daniel RK, Glasz T, Molnar G et al (2013) The lower nasal base: an anatomical study. Aesthet Surg J 33(2):222–232CrossRefPubMed
24.
go back to reference Saban Y, Andretto Amodeo C, Hammou JC et al (2008) An anatomical study of the nasal superficial musculoaponeurotic system: surgical applications in rhinoplasty. Arch Facial Plast Surg 10(2):109–115CrossRefPubMed Saban Y, Andretto Amodeo C, Hammou JC et al (2008) An anatomical study of the nasal superficial musculoaponeurotic system: surgical applications in rhinoplasty. Arch Facial Plast Surg 10(2):109–115CrossRefPubMed
25.
go back to reference Kosins AM, Lambros V, Daniel RK (2014) The plunging tip: illusion and reality. Aesthet Surg J 34(1):45–55CrossRefPubMed Kosins AM, Lambros V, Daniel RK (2014) The plunging tip: illusion and reality. Aesthet Surg J 34(1):45–55CrossRefPubMed
Metadata
Title
Effect of the Depressor Septi Nasi Muscle Modification on Nasal Tip Rotation and Projection
Authors
Javad S. Toutounchi
Sogol H. Biroon
Samira M. Banaem
Neghisa S. Toutounchi
Nariman Nezami
Behzad Salari
Publication date
01-06-2015
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 3/2015
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-015-0469-9

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