Facial Plast Surg
DOI: 10.1055/a-2318-0866
Original Research

Twelve Steps to Optimize Scar Outcomes in External Rhinoplasty

1   International Fellow of the European Academy of Facial Plastic Surgery, Ege University, Izmir, Turkiye
,
Meshari Saghir
2   Facial Plastic Surgeon and ENT Specialist, Al Jahra Hospital, Al Jahra, Kuwait
,
Fazil Apaydin
3   Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology, Ege University, Izmir, Turkiye
› Institutsangaben

Abstract

A well-healed scar extends beyond a mere superficial concern, reflecting the precision and care underlying the surgery. This study addresses the lack of recent literature on the complete closure technique for external rhinoplasty scars, emphasizing its potential impact on patient satisfaction and overall aesthetic quality. The main purpose of this article was to introduce and assess the efficacy of a novel closing suture technique for external rhinoplasty and emphasize on 12 specific steps for wound closure. A cohort of 104 patients who underwent external rhinoplasty utilizing the proposed closing suture technique were evaluated. Standardized photographic documentation and scar assessment were performed using the Vancouver–Manchester scale, considering notching, skin level differences, pigmentation, and overall appearance. The surgical approach involved a combination of vertical mattress and interrupted simple sutures, creating an effective closure framework. Analysis revealed an absence of poor scars, with 83.6% classified as good. Note that 65.5% of the good scars achieved a perfect 6-point score. While one moderate scar scored 3 points, the majority demonstrated optimal outcomes. Clinical photographs further illustrated the technique's success, showcasing imperceptible scars and reinforcing the efficacy of the complete closure approach. Our study introduces and assesses the efficacy of the complete closure technique for external rhinoplasty scars. The approach consistently yields positive outcomes, with an emphasis on almost imperceptible scars. While not achieving a 100% imperceptible scar rate, this study underscores the need for ongoing research to refine techniques and enhance patient satisfaction in external rhinoplasty. The proposed technique contributes significantly to scar management practices and encourages further exploration within the evolving landscape of rhinoplasty.

Authors' Contributions

G.A.S.-G.: conception, acquisition of data, analysis, interpretation of data, draft revision, and final approval.


F.A.: analysis, draft revision, and final approval.


M.S.: draft revision and final approval.




Publikationsverlauf

Accepted Manuscript online:
02. Mai 2024

Artikel online veröffentlicht:
30. Mai 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Devgan L, Singh P, Durairaj K. Minimally invasive facial cosmetic procedures. Otolaryngol Clin North Am 2019; 52 (03) 443-459
  • 2 Guerrerosantos J. Open rhinoplasty without skin-columella incision. Plast Reconstr Surg 1990; 85 (06) 955-960
  • 3 Soto-Galindo GA. Beyond the scalpel: unraveling the external vs. closed approach, a rhinoplasty conundrum. Acta Sci Otolaryngol 2023; 5 (09) 01-02
  • 4 Bafaqeeh SA, Al-Qattan MM. Open rhinoplasty: columellar scar analysis in an Arabian population. Plast Reconstr Surg 1998; 102 (04) 1226-1228 , discussion 1229
  • 5 Inanli S, Sari M, Yanik M. A new consideration of scar formation in open rhinoplasty. J Craniofac Surg 2009; 20 (04) 1228-1230
  • 6 Adamson PA, Smith O, Tropper GJ. Incision and scar analysis in open (external) rhinoplasty. Arch Otolaryngol Head Neck Surg 1990; 116 (06) 671-675
  • 7 Erol O, Buyuklu F, Koycu A, Jafarov S, Gultekin G, Erbek SS. Comparison of rapid absorbable sutures with nonabsorbable sutures in closing transcolumellar incision in septorhinoplasty: short-term outcomes. Aesthetic Plast Surg 2020; 44 (05) 1759-1765
  • 8 Foda HM. External rhinoplasty for the Arabian nose: a columellar scar analysis. Aesthetic Plast Surg 2004; 28 (05) 312-316
  • 9 Gizzi A, Cherubini C, Pomella N, Persichetti P, Vasta M, Filippi S. Computational modeling and stress analysis of columellar biomechanics. J Mech Behav Biomed Mater 2012; 15 (01) 46-58
  • 10 Aksu I, Alim H, Tellioğlu AT. Comparative columellar scar analysis between transverse and inverted-V incision in open rhinoplasty. Aesthetic Plast Surg 2008; 32 (04) 638-640
  • 11 Saedi B, Amali A, Taibnama N, Most SP. Comparison of the aesthetic results of two common incisions in external rhinoplasty: a randomized trial. Am J Rhinol Allergy 2016; 30 (04) 310-312
  • 12 Papel ID. Facial Plastic and Reconstructive Surgery. 4th ed.. New York, NY: Thieme; 2016
  • 13 Alinasab B, Haraldsson PO. Rapid resorbable sutures are a favourable alternative to non-resorbable sutures in closing transcolumellar incision in rhinoplasty. Aesthetic Plast Surg 2016; 40 (04) 449-452
  • 14 Ashraf N, Foden N, D'Souza A. Closure of the trans-columellar incision in open septorhinoplasty in 100 patients: use of an absorbable multifilament suture. Clin Otolaryngol 2017; 42 (05) 1085-1087
  • 15 Khansa I, Harrison B, Janis JE. Evidence-based scar management: how to improve results with technique and technology. Plast Reconstr Surg 2016; 138 (3, Suppl): 165S-178S
  • 16 Serin GM, Polat S, Aksoy E, İnanlı S. Postoperative wound care regimen in open septorhinoplasty. J Craniofac Surg 2010; 21 (06) 1880-1881