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ORIGINAL RESEARCH

The Effect of Nasal Tip Rotation on Upper Lip Length and Projection
Nazal Tip Rotasyonunun Üst Dudak Uzunluğuna ve Projeksiyonuna Etkisi
Received Date : 27 Dec 2020
Accepted Date : 29 Mar 2021
Available Online : 05 Apr 2021
Doi: 10.24179/kbbbbc.2020-80843 - Makale Dili: TR
KBB ve BBC Dergisi. 2021;29(3):161-7
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Increasing the nasolabial angle with nasal tip rotation in tip surgery in rhinoplasty may cause the lower 1/3 of the face to look longer. In particular, it can be perceived as an increase in upper lip length. The aim of this study is to compare the effects of two types of surgical techniques, that enhance tip rotation, on nasolabial angle; upper lip projection and upper lip length. Material and Methods: Preoperative, early postoperative and late postoperative photographs of 78 patients who underwent rhinoplasty with application of tongue-in-groove or columellar strut maneuvers were examined. The outcome measures were determined as postoperative nasolabial angle, upper lip projection angle and upper lip length, which were calculated in the computer program. Results: Columellar strut was applied in 46 patients (59%), tongue in groove was applied in 32 patients (41%). Nasolabial angle increased significantly in both groups (p=0.01). In the both group, the upper lip length increased significantly (p=0.01). The Z angle was found to be decreased in both columellar strut and tongue-in-groove groups, inversely proportional to the projection (3 and 4.8 degrees, respectively). Conclusion: Both columellar strut and tongue in groove maneuvers are effective in increasing the rotation. With these techniques applied in tip surgery, the length and projection of the upper lip increases. It was found that, for each one degree increment in nasolabial angle, the length of the upper lip increased by 0.03 mm using the columellar strut technique and 0.04 mm using the tongue-in-groove technique.
ÖZET
Amaç: Rinoplastide tip cerrahisinde nazal tip rotasyonuyla nazolabial açının artırılması, yüz alt 1/3 bölümünün uzunluğunun artmış olarak görünmesine sebep olabilmektedir. Özellikle de üst dudak uzunluğunda bir artış olarak algılanabilmektedir. Çalışmanın amacı, tip rotasyonunu artıran 2 tip cerrahisi tekniğinin nazolabial açıya, üst dudak projeksiyonuna ve üst dudak uzunluğuna etkisini karşılaştırmaktır. Gereç ve Yöntemler: “Tongue-in-groove” ya da kolumellar strut uygulanmış olan 78 hastanın preoperatif, erken postoperatif ve geç postoperatif fotoğrafları incelenerek nazolabial açı, üst dudak projeksiyon açısı ve üst dudak uzunluğu olmak üzere 3 parametre bilgisayar programında hesaplanmıştır. Bulgular: Kolumellar strut uygulanan hasta sayısı 46 (%59), “tongue-in-groove” uygulanan hasta sayısı ise 32 (%41) idi. Nazolabial açı her 2 grupta da anlamlı derecede artış göstermiştir (p=0,01). Her 2 grupta üst dudak uzunluğunu anlamlı olarak artırmıştır (p=0,01). Üst dudak projeksiyonuyla ilişkili açı olan Z açısı, projeksiyonla ters orantılı olarak kolumellar strut grubunda da “tonguein- groove” grubunda da sırasıyla 3 ve 4,8 derece azalmış olarak saptanmıştır. Sonuç: Hem kolumellar strut hem de “tongue-in-groove” tip rotasyonunu artırmak için etkili manevralardır. Rinoplastide, tip cerrahisinde uygulanan bu tekniklerle üst dudak uzunluğu ve projeksiyonu artmaktadır. Nazolabial açının her bir derecelik artışında, üst dudak uzunluğunun, kolumellar strut tekniğinde 0,03 mm, “tongue-in-groove” tekniğinde 0,04 mm arttığı saptanmıştır.
KAYNAKLAR
  1. Saleh HA, Beegun I, Apaydin F. Outcomes in rhinoplasty. Facial Plast Surg. 2019;35(1):47-52. [Crossref] 
  2. van Zijl FVWJ, Mokkink LB, Haagsma JA, Datema FR. Evaluation of measurement properties of patient-reported outcome measures after rhinoplasty: a systematic review. JAMA Facial Plast Surg. 2019;1;21(2):152-62. [Crossref]  [PubMed] 
  3. Toriumi DM. Structure concept in nasal tip surgery. Operative Techniques in Plastic and Reconstructive Surgery. 2000;7(4):175-86. [Crossref] 
  4. Apaydin F. Projection and deprojection techniques in rhinoplasty. Clin Plast Surg. 2016;43(1):151-68. [Crossref]  [PubMed] 
  5. Bucher S, Kunz S, Deggeller M, Holzmann D, Soyka MB. Open rhinoplasty using a columellar strut: effects of the graft on nasal tip projection and rotation. Eur Arch Otorhinolaryngol. 2020;277(5):1371-7. [Crossref]  [PubMed] 
  6. Erol O, Buyuklu F, Koycu A, Bas C, Erbek SS. Evaluation of nasal tip support in septorhinoplasty. Aesthetic Plast Surg. 2019;43(4):1021-7. [Crossref]  [PubMed] 
  7. Datema FR, Lohuis PJ. The tongue-in-groove technique in primary and revision rhinoplasty. Facial Plast Surg. 2016;32(4):416-23. [Crossref]  [PubMed] 
  8. Cakir B. Analysis&Surgical Planning. In:Saban Y, Cakir B, Daniel R, Palhazi P, editors. Preservation Rhinoplasty. 3th Edition. Istanbul: Bio Ofset; 2018. p.33-44. [Link] 
  9. Erol O. Preoperatif değerlendirme ve fasiyal analiz. Erbek S, editör. Güncel Burun ve Sinüs Cerrahisi. 1. Baskı Ankara: Aydede Yayıncılık; 2017. p.91-100. [Link] 
  10. Maliniak JW. Sculpture in the Living: Rebuilding the Face and Form by Plastic Surgery. 1st ed. Pierson; 1934. (Baskı yeri eklenmelidir.) [Link] 
  11. Kosins AM, Lambros V, Daniel RK. The plunging tip: illusion and reality. Aesthet Surg J. 2014;1;34(1):45-55. [Crossref]  [PubMed] 
  12. Papel ID. Facial analysis and nasal aesthetics. Aesthetic Plast Surg. 2002;26 Suppl 1:S13. [Crossref]  [PubMed] 
  13. Kridel RW, Scott BA, Foda HM. The tongue-in-groove technique in septorhinoplasty. A 10-year experience. Arch Facial Plast Surg. 1999;1(4):246-56; discussion 257-8. [Crossref]  [PubMed] 
  14. Aksakal C. Comparing the effects of tongue-in-groove and septocolumellar suture with short and floating columellar strut of open rhinoplasty on nasal tip rotation and projection. J Oral Maxillofac Surg. 2021;79(2):474.e1-e11. [Crossref]  [PubMed] 
  15. Khabir F, Sezavar M, Bohluli B, Mesgarzadeh V, Tavakoli H. The effect of the tongue in groove technique on the nasolabial angle and nasal tip projection. Maxillofac Plast Reconstr Surg. 2020;8;42(1):19. [Crossref]  [PubMed]  [PMC] 
  16. Merrifield LL. The profile line as an aid in critically evaluating facial esthetics. Am J Orthod. 1966;52(11):804-22. [Crossref]  [PubMed] 
  17. Zimbler MS, Kokoska MS, Thomas JR. Anatomy and pathophysiology of facial aging. Facial Plast Surg Clin North Am. 2001;9(2):179-87, vii. [PubMed] 
  18. Cerrati EW, Dayan SH. Association of increasing nasal tip projection with lip position in primary rhinoplasty. JAMA Facial Plast Surg. 2017;1;19(4):323-6. [Crossref]  [PubMed]  [PMC] 
  19. Uysal T, Yagci A, Basciftci FA, Sisman Y. Standards of soft tissue Arnett analysis for surgical planning in Turkish adults. Eur J Orthod. 2009;31(4):449-56. [Crossref]  [PubMed] 
  20. Perkins K, Shah A, Patel A, Steinbacher D. The effect of nasal tip rotation on upper lip length. Aesthet Surg J. 2017;1;37(5):504-10. [PubMed] 
  21. Mendelson B, Wong CH. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthetic Plast Surg. 2012;36(4):753-60. [Crossref]  [PubMed]  [PMC] 
  22. Penna V, Stark G, Eisenhardt SU, Bannasch H, Iblher N. The aging lip: a comparative histological analysis of age-related changes in the upper lip complex. Plast Reconstr Surg. 2009;124(2):624-8. [Crossref]  [PubMed] 
  23. Gunn DA, Rexbye H, Griffiths CE, Murray PG, Fereday A, Catt SD, et al. Why some women look young for their age. PLoS One. 2009;1;4(12):e8021. [Crossref]  [PubMed]  [PMC] 
  24. Kosins AM. Commentary on: the effect of nasal tip rotation on upper lip length. Aesthet Surg J. 2017;1;37(5):511-4. [Crossref]  [PubMed]