Clinical Implications of Pitanguy Ligament Management for Nasal Tip Contouring in Open versus Closed Rhinoplasty.

backgroundSeveral modalities have been developed to achieve precise tip contouring and address postsurgical edema. This comparative study aimed to analyze the short- and long-term effects of the Pitanguy ligament management on nasal tip aesthetics and postsurgical edema in open versus closed rhinoplasty.

methodsPatients were divided into three groups, each comprising 40 individuals. Group I (open rhinoplasty without ligament repair), Group II (open rhinoplasty with ligament repair), and Group III (closed rhinoplasty with ligament preservation). All patients included in the study were evaluated for the depth of the supratip area, nasal tip edema, rotations, projections and completed the Rhinoplasty Outcome Evaluation questionnaire.

resultsThe depth of the supratip area and tip edema were significantly different in group I than in groups II and III in early postoperative follow-ups (p<0.001). The Goode score and nasolabial angle were significantly different between groups I and III in the early postoperative period (p<0.05). However, there were no statistically significant differences in the depth of the supratip area, tip edema, and Goode score at 12 months postoperatively among the groups.

conclusionsPrecise control of the cartilaginous framework and soft-tissue covering combines the concepts that provide control of the projection, position, and rotation of the nasal tip in the long-term. Although subsiding initial edema and improved supratip definition were achieved in the early postoperative follow-up, there were no differences between the results of the surgeries in all groups in the long-term. 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 .