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  • Title: Revision Rhinoplasty for Short Noses in the Asian Population.
    Author: Lan MY, Jang YJ.
    Journal: JAMA Facial Plast Surg; 2015; 17(5):325-32. PubMed ID: 26111006.
    Abstract:
    IMPORTANCE: Short nose, especially postoperative short nose in Asian patients, remains a challenging problem for plastic surgeons. OBJECTIVE: To determine the outcomes of revision rhinoplasty of postoperative short noses in Asian patients. DESIGN, SETTING, AND PARTICIPANTS: We performed a retrospective medical record review of 41 Asian patients with postoperative short nose who underwent revision rhinoplasty in a tertiary care referral center in South Korea from October 1, 2006, through August 31, 2014. MAIN OUTCOMES AND MEASURES: Patient demographic, surgical technique, graft use, anthropometric measurement, complication, and aesthetic outcome assessment data were retrieved. RESULTS: The 41 enrolled patients were a mean (SD) of 36.5 (12.6) years old. There were 16 men and 25 women. The most commonly used dorsal graft in the previous rhinoplasty was silicone, followed by fascia with or without cartilage. Various surgical techniques were applied, including septal reconstruction, cartilage flap technique, tip surgery, lateral compartment correction, and dorsal augmentation. Autologous costal cartilage was the most commonly used septal reconstruction material. Eleven patients (27%) developed postoperative complications, including infection, nostril asymmetry, and pollybeak deformity. Revision rhinoplasty yielded statistically significant improvements in nasal length (increase of 12.0%, P < .001), nasal tip projection (increase of 13.4%, P < .001), nasofrontal angle (decrease of 2.39°, P = .04), nasolabial angle (decrease of 7.62°, P < .001), and columella-lobular angle (increase of 3.25°, P < .001). More than 90% (37) of the patients were judged to have good or excellent aesthetic results. CONCLUSIONS AND RELEVANCE: Correction of postoperative short nose in Asian patients requires complicated surgery that usually involves more than one kind of surgical technique. Complications are not uncommon, and patients should be informed of this before surgery. LEVEL OF EVIDENCE: 4.
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