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Clinical evaluation of safety and complications of the nasal tip defatting in rhinoplasty

Feizollah Niazi, Sana Niazi, Hamidreza Alizadeh Otaghvar, Farhood Goravanchi




Objective: Nasal tip refinement is an important objective in aesthetic rhinoplasty and one of the surgical options for soft tissue management in very thick bulbous skin and subcutaneous noses is tip defatting. The aim of this study was to evaluate the safety and complications of tip defatting in thick skin and bulbous noses.



Methods: Among 527 patients that underwent rhinoplasty in Modaress hospital between February 2011 and January 2014, nasal tip defatting were performed in 162 of these patients. Intraoperatively and in follow up examinations, any signs of skin congestion, ischemia, hematoma, and skin quality evaluated.



Results: Among 162 patients who had performed tip defatting [39 (24.1%) male patients and 123 (75.9%) female], complications were skin congestion in 6 patients (3.7%), ecchymosis in 10 patient (6.1%). There were no cases of skin necrosis, skin perforations or skin irregularity.



Conclusion: Our study and many previous studies show that tip defatting in association with lower lateral cartilage reduction is a safe and helpful method in correction of bulbous nose deformity



Defatting;Rhinoplasty;Nasal tip


Tardy ME, Alex J, Bailey BJ, Hendrick D, Dayan S. Surgical anatomy of the nose. In: Bailey BJ, Calhoun KH, Healy GB, Jackler RK, et al., eds. Head and Neck Surgery–Otolaryngology. 3rd Ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2001:2213–2218.

Tardy ME. Rhinoplasty: The Art and the Science. Philadelphia, PA: WB Saunders; 1997:57–65.

Shadman Nemati, MD; Rahmatollah Banan, MD; Ahmad Alizadeh, MD; Ehsan Kazemnejad Leili, MD; Hassan Kerdari, MD. Ultrasonographic Evaluation of Long-term Results of Nasal Tip Defatting in Rhinoplasty Cases. Laryngoscope. 2013: Sep; 123 (9):2131-5

R. Banan, SH. Nemati, A. Alizadeh, E. Kazemnezhad, H. Kerdari, F. Bakhshi. Sonographic evaluation of nasal tip skin stickness among patients undergoing rhinoplasty with or without defatting. JQUMS, Vol.16, No.2, Summer 2012, pp.21-27

Rohrich RJ, Gunter JP, Friedman RM. Nasal tip blood supply: an anatomic study validating the safety of the transcolumellar incision in rhinoplasty. Plast Reconstr Surg. 1995 Apr;95(5):795-9; discussion 800-1

Zingaro E.A. and Falces E.: Aesthetic anatomy of the non-Caucasian nose. Plast. Surg. Clin., 14: 749, 1987.

Peck G.C. and Michelson L.N.: Anatomy of aesthetic surgery of the nose. Facial aesthetic surgery clinics in Plastic Sargery, Vol. 14, No. 4, 1987.

AHMED M. ALBARAH, M.D. Thick Skin Nose, Rhinoplasty. Egypt, J. Plast. Reconstr. Surg., Vol. 36, No. 1, January: 91-96, 2012

Behmand RA, Ghavami A, Guyuron B. Nasal tip sutures part I: the evolution. Plast Reconstr Surg 2003; 112(4): 1146-9.

Murrell GL. Auricular cartilage grafts and nasal surgery. Laryngoscope 2004; 114(12): 2092-102.

Ali Ghazipour, Nader Saki, Fereydon Eslamijoo. Comparison of suture and vertical dome division techniques of bulbous nose refinement. Apadana Journal of Clinical Research 2012;1:26-32.

Constantian MB. The boxy nasal tip, the ball tip, and alar cartilage malposition: variations on a theme -a study in 200 consecutive primary and secondary rhinoplasty patients. Plast Reconstr Surg 2005; 116(1): 268-81.

Mckinney P.Management of the bulb's nose. Plast Reconstr Surg 2000; 106 (4): 906-17.

George K. Sun, MD; Derek S. Lee, MD; Alvin I. Glasgold, MD. Interdomal Fat Pad. An Important Anatomical Structure in Rhinoplasty. Arch Facial Plast Surg. 2000;2(4):260-263.

Azizzadeh B, Murphy MR, Johnson CM, et al. Master techniques in rhinoplasty. Philadelphia: Elsevier Saunders; 2011.

Steele NP, Thomas JR. In: Stucker FJ, Souza C de, Kenyon GS, et al., Editors. Rhinoplasty and facial plastic surgery. New York: Springer; 2009 5-12.

Jewett BS, Baker SR. In: Baker SR, editor. Principles of nasal reconstruction. New York: Springer; 2011 13-22.

McKinney P. Management of the bulb's nose. Plast Reconstr Surg 2000; 106: 906-17.

Mao GY, Yang SL, Zheng JH, et al. Aesthetic rhinoplasty of the Asian nasal tip: a brief review. Aesthetic Plast Surg 2008; 32: 632-7.

Da Arm Kim, Jae Yong Jeong, Sang Ha OH. Bulbous Tip Correction Focusing on Skin Soft Tissue Envelope in Asian Rhinoplasty. Arch Aesthetic Plast Surg 2014; 20 (3): 140-147.

Toriumi DM, Mueller RA, Grosch T, et al. Vascular anatomy of the nose and the external rhinoplasty approach. Arch Otolaryngol Head Neck Surg. 1996; 122: 24-34.

Rohrich R.J. and Muzaffar A.R.M .: Rhinoplasty in the African-American Patient. Plast Reconstr. Surg. 111 (3): 1322, 2003.

Elizabeth G. Whitaker, M.D., and Calvin M. Johnson, Jr., M.D. Skin and Subcutaneous Tissue in Rhinoplasty. Aesthetic Plast Surg. 2002 Nov; 26 Suppl 1: S19

Ahmed Elshahat, MD. Triple Plane Dissection in Open Primary Rhinoplasty in Middle Eastern Noses. Eplasty Aug 5, 2013; 13: e40. eCollection 2013


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