A multivariate analysis of nasal tip deprojection

Jacob G. Unger, Michael R. Lee, Robert K. Kwon, Rod J. Rohrich

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background:: Projection of the nasal tip is a complex problem that often mandates attention during rhinoplasty. Occasionally, the goal is to decrease tip projection. Most published solutions to this problem involve division or manipulation of the lower lateral cartilages, although objective data on the efficacy of these techniques are limited. This study reviews a series of rhinoplasties and determines which maneuvers had the greatest effect on tip projection. Methods:: One hundred twenty-five consecutive rhinoplasties performed by a single surgeon in a university setting were reviewed. Charts were analyzed for surgical indications and technical steps performed in the operating room. Preoperative and postoperative photographs underwent multivariate analysis to determine changes in nasal projection and which factors contribute to affecting tip projection. Results:: Overall revision rate was 3.8 percent. Cartilage-splitting techniques were used in only 2.4 percent of cases. Multivariate dummy variable analysis revealed that only dorsal component reduction and caudal trim were associated with significant decreases in tip projection. Alar base resection did not change absolute tip position but did have a marked effect on the position of the alar-cheek junction and thus the overall balance of the nose with regard to length-to-projection ratios and projection proportions. Conclusions:: Cartilage-dividing techniques are rarely necessary to reduce projection. Release of the soft-tissue attachments of the lower lateral cartilages and modification of the anterior septum are frequently sufficient to achieve a satisfactory aesthetic endpoint. Alar base resection has a complex interaction with nasal aesthetics with regard to tip projection.

Original languageEnglish (US)
Pages (from-to)1163-1167
Number of pages5
JournalPlastic and Reconstructive Surgery
Volume129
Issue number5
DOIs
StatePublished - May 2012

Fingerprint

Nose
Rhinoplasty
Cartilage
Multivariate Analysis
Esthetics
Cheek
Operating Rooms
daminozide

ASJC Scopus subject areas

  • Surgery

Cite this

A multivariate analysis of nasal tip deprojection. / Unger, Jacob G.; Lee, Michael R.; Kwon, Robert K.; Rohrich, Rod J.

In: Plastic and Reconstructive Surgery, Vol. 129, No. 5, 05.2012, p. 1163-1167.

Research output: Contribution to journalArticle

Unger, Jacob G. ; Lee, Michael R. ; Kwon, Robert K. ; Rohrich, Rod J. / A multivariate analysis of nasal tip deprojection. In: Plastic and Reconstructive Surgery. 2012 ; Vol. 129, No. 5. pp. 1163-1167.
@article{ebce8721617743209e7fef2bbd250d02,
title = "A multivariate analysis of nasal tip deprojection",
abstract = "Background:: Projection of the nasal tip is a complex problem that often mandates attention during rhinoplasty. Occasionally, the goal is to decrease tip projection. Most published solutions to this problem involve division or manipulation of the lower lateral cartilages, although objective data on the efficacy of these techniques are limited. This study reviews a series of rhinoplasties and determines which maneuvers had the greatest effect on tip projection. Methods:: One hundred twenty-five consecutive rhinoplasties performed by a single surgeon in a university setting were reviewed. Charts were analyzed for surgical indications and technical steps performed in the operating room. Preoperative and postoperative photographs underwent multivariate analysis to determine changes in nasal projection and which factors contribute to affecting tip projection. Results:: Overall revision rate was 3.8 percent. Cartilage-splitting techniques were used in only 2.4 percent of cases. Multivariate dummy variable analysis revealed that only dorsal component reduction and caudal trim were associated with significant decreases in tip projection. Alar base resection did not change absolute tip position but did have a marked effect on the position of the alar-cheek junction and thus the overall balance of the nose with regard to length-to-projection ratios and projection proportions. Conclusions:: Cartilage-dividing techniques are rarely necessary to reduce projection. Release of the soft-tissue attachments of the lower lateral cartilages and modification of the anterior septum are frequently sufficient to achieve a satisfactory aesthetic endpoint. Alar base resection has a complex interaction with nasal aesthetics with regard to tip projection.",
author = "Unger, {Jacob G.} and Lee, {Michael R.} and Kwon, {Robert K.} and Rohrich, {Rod J.}",
year = "2012",
month = "5",
doi = "10.1097/PRS.0b013e31824a2e05",
language = "English (US)",
volume = "129",
pages = "1163--1167",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - A multivariate analysis of nasal tip deprojection

AU - Unger, Jacob G.

AU - Lee, Michael R.

AU - Kwon, Robert K.

AU - Rohrich, Rod J.

PY - 2012/5

Y1 - 2012/5

N2 - Background:: Projection of the nasal tip is a complex problem that often mandates attention during rhinoplasty. Occasionally, the goal is to decrease tip projection. Most published solutions to this problem involve division or manipulation of the lower lateral cartilages, although objective data on the efficacy of these techniques are limited. This study reviews a series of rhinoplasties and determines which maneuvers had the greatest effect on tip projection. Methods:: One hundred twenty-five consecutive rhinoplasties performed by a single surgeon in a university setting were reviewed. Charts were analyzed for surgical indications and technical steps performed in the operating room. Preoperative and postoperative photographs underwent multivariate analysis to determine changes in nasal projection and which factors contribute to affecting tip projection. Results:: Overall revision rate was 3.8 percent. Cartilage-splitting techniques were used in only 2.4 percent of cases. Multivariate dummy variable analysis revealed that only dorsal component reduction and caudal trim were associated with significant decreases in tip projection. Alar base resection did not change absolute tip position but did have a marked effect on the position of the alar-cheek junction and thus the overall balance of the nose with regard to length-to-projection ratios and projection proportions. Conclusions:: Cartilage-dividing techniques are rarely necessary to reduce projection. Release of the soft-tissue attachments of the lower lateral cartilages and modification of the anterior septum are frequently sufficient to achieve a satisfactory aesthetic endpoint. Alar base resection has a complex interaction with nasal aesthetics with regard to tip projection.

AB - Background:: Projection of the nasal tip is a complex problem that often mandates attention during rhinoplasty. Occasionally, the goal is to decrease tip projection. Most published solutions to this problem involve division or manipulation of the lower lateral cartilages, although objective data on the efficacy of these techniques are limited. This study reviews a series of rhinoplasties and determines which maneuvers had the greatest effect on tip projection. Methods:: One hundred twenty-five consecutive rhinoplasties performed by a single surgeon in a university setting were reviewed. Charts were analyzed for surgical indications and technical steps performed in the operating room. Preoperative and postoperative photographs underwent multivariate analysis to determine changes in nasal projection and which factors contribute to affecting tip projection. Results:: Overall revision rate was 3.8 percent. Cartilage-splitting techniques were used in only 2.4 percent of cases. Multivariate dummy variable analysis revealed that only dorsal component reduction and caudal trim were associated with significant decreases in tip projection. Alar base resection did not change absolute tip position but did have a marked effect on the position of the alar-cheek junction and thus the overall balance of the nose with regard to length-to-projection ratios and projection proportions. Conclusions:: Cartilage-dividing techniques are rarely necessary to reduce projection. Release of the soft-tissue attachments of the lower lateral cartilages and modification of the anterior septum are frequently sufficient to achieve a satisfactory aesthetic endpoint. Alar base resection has a complex interaction with nasal aesthetics with regard to tip projection.

UR - http://www.scopus.com/inward/record.url?scp=84860768033&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84860768033&partnerID=8YFLogxK

U2 - 10.1097/PRS.0b013e31824a2e05

DO - 10.1097/PRS.0b013e31824a2e05

M3 - Article

C2 - 22544098

AN - SCOPUS:84860768033

VL - 129

SP - 1163

EP - 1167

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 5

ER -