Tip Surgery in Dorsal Preservation Rhinoplasty: The Effect of Modified Low Septal Strip Septoplasty on Tip Plasty

Çelik V, Tuluy Y, Çakır Bozkurt G.

PubMed 38977457 Publisher (DOI)Free full text (PMC)

What this paper says

In 189 dorsal preservation rhinoplasties using a modified low septal strip with septal extension graft and tongue-in-groove tip fixation, only 2 patients (1.1%) needed revision, both for residual hump and none for the tip.

Overview

Tip surgery in preservation rhinoplasty must still deliver rotation, projection and their opposites. The Turkish authors retrospectively reviewed 189 patients who had dorsal preservation with a modified low septal strip septoplasty between November 2021 and August 2023, combined with a septal extension graft, tongue-in-groove and other suture manoeuvres, recording complications, revisions and follow-up.

Sections of note

189 patients; mean age 29.58 (range 17-65).
Mean follow-up 14.5 months.
Complications in 2 of 189 (1.1%), both residual hump, treated by rasping under local anaesthesia.
No tip revisions in any patient.
Level of Evidence II (as assigned by the journal).

What it means for a patient

Preservation of the bridge does not prevent the surgeon from doing full tip work; in this series the tip held in every case.
The residual-hump rate of about 1% is low compared with other preservation series.
The results are one team's retrospective count without patient-reported scores.

Why this paper matters

It shows tip fixation can be integrated into a low-strip preservation operation with a low revision rate in a sizeable series. Limits: retrospective, single centre, no validated outcome measures in the abstract.

Terms

Low septal strip: removing cartilage at the base of the septum so the intact dorsum can drop.
Septal extension graft: cartilage fixed to the septum to control tip position.
Tongue-in-groove (TIG): suturing the medial crura over the caudal septum.
Residual hump: a bump left on the bridge after surgery.
Rasping: filing down bone or cartilage.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

Abstract

Background: The aim in tip surgery is to provide rotation, derotation, projection and deprojection. In this study, we aimed to show the effects of modified low septal strip septoplasty, septal extension graft, TIG technique and additional maneuvers on tip shape in dorsal preservation rhinoplasty (DPR) and to discuss our clinical results.

Patients And Methods: One hundred eighty-nine patients who underwent DPR with modified low septal strip septoplasty between November 2021 and August 2023 were included in the study. Demographic data, complications, revision surgeries and follow-up periods of the patients were analyzed retrospectively.

Results: The mean age of the patients is 29.58±9.04 (17-65). The mean follow-up period was 14, 50±2,98 months. Complications were observed in 1.1% of the patients (n=2/189). Revision surgery was performed in all these patients. Residual hump in 2 were observed and dorsum rasping was performed under local anesthesia. No tip revision was performed on any patient.

Conclusions: A strong tip fixation is achieved with the modified low septal septoplasty technique described in this publication, and when combined with septal extension graft, tongue in groove technique and other suture techniques, an effective and permanent tip plasty can be performed in DPR.

Level Of Evidence Ii: 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 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).