Download PDF
Facial Plast Surg 2025; 41(03): 377-385
DOI: 10.1055/a-2353-3477
Original Research

Impact of Tongue-in-Groove Technique on Smile and Lip Position: A Comparative Analysis with and without Septal Extension Graft

Farbod Farhbaksh
1   Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran
,
Amir Arvin Sazgar
1   Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran
,
Babak Saedi
1   Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

This study was conducted to compare the outcomes of the tongue-in-groove (TIG) technique with and without septal extension graft (SEG) on smile and lip position in rhinoplasty. Fifty-eight rhinoplasty patients, treated at a tertiary referral center between 2020 and 2022, underwent preoperative and 12-month postoperative evaluations, using the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) and the visual analog scale (VAS). The preoperative and 12-month postoperative photographs were analyzed using Adobe Photoshop to assess changes in lip and smile positions. The study included 38 patients in the TIG with SEG group and 20 patients in the TIG without SEG group. The participants, with an average age of 32.12 ± 7.97 years, comprised 81% females. In terms of surgical outcomes, postoperative evaluations revealed significant improvements in the VAS aesthetic score, SCHNOS-O score, and SCHNOS-C score compared with preoperative scores (p < 0.001) for both groups. Notably, both groups demonstrated significant improvements in the upper lip length, nasolabial angle (NLA), columellar inclination (CI) angle, and smile NLA. Patients in the SEG group exhibited markedly superior SCHNOS-O results, as well as distinctions in smile NLA and smile CI, compared with the group without SEG. The impact of rhinoplasty techniques on lip and smile remains complex requiring further evaluation. Both of the TIG techniques, with and without SEG, resulted in positive outcomes in terms of improving lip and smile positions, with the use of SEG demonstrating greater stability during a smile.

Keywords

rhinoplasty - graft - lip - nasal septum - tongue-in-groove - septal extension graft - smile - lip position


Publication History

Accepted Manuscript online:
26 June 2024

Article published online:
22 July 2024

© 2024. Thieme. All rights reserved.

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

 

  • References

  • 1 Arli C, Bilgic F, Kaya A, Arpag OF. Effects of rhinoplasty on smile esthetic and gingival appearance. J Craniofac Surg 2020; 31 (03) 689-691
    CrossrefPubMedSearch in Google Scholar
  • 2 Brady C, Berwick D, Uppal R. Tip droop prevention in rhinoplasty: dynamic effect of strut graft on smiling versus depressor muscle release. Plast Reconstr Surg Glob Open 2021; 9 (04) e3462
    CrossrefPubMedSearch in Google Scholar
  • 3 Pi H, Kurlander DE, Guyuron B. Effects of the rhinoplasty maneuvers on upper lip position and incisor show. Aesthetic Plast Surg 2017; 41 (01) 135-139
    CrossrefPubMedSearch in Google Scholar
  • 4 Kosins AM, Obagi ZE. Managing the difficult soft tissue envelope in facial and rhinoplasty surgery. Aesthet Surg J 2017; 37 (02) 143-157
    CrossrefPubMedSearch in Google Scholar
  • 5 Rahavi-Ezabadi S, Most SP, Saltychev M, Sazgar AA, Moubayed SP, Saedi B. Validation of the Persian language version of the standardized cosmesis and health nasal outcomes survey (SCHNOS). JAMA Facial Plast Surg 2018; 20 (06) 521-523
    CrossrefPubMedSearch in Google Scholar
  • 6 Cerrati EW, Dayan SH. Association of increasing nasal tip projection with lip position in primary rhinoplasty. JAMA Facial Plast Surg 2017; 19 (04) 323-326
    CrossrefPubMedSearch in Google Scholar
  • 7 Ho Y, Deeb R, Westreich R, Lawson W. Effect of depressor septi resection in rhinoplasty on upper lip length. JAMA Facial Plast Surg 2014; 16 (04) 272-276
    CrossrefPubMedSearch in Google Scholar
  • 8 Mohebbi A, Dehghani Firouzabadi F, Dehghani Firouzabadi M, Roomiani M. Effect of the tongue-in-groove technique on the smile form. Rhinology 2020; 58 (06) 626-628
    CrossrefPubMedSearch in Google Scholar
  • 9 Talei B. The modified upper lip lift: advanced approach with deep-plane release and secure suspension: 823-patient series. Facial Plast Surg Clin North Am 2019; 27 (03) 385-398
    CrossrefPubMedSearch in Google Scholar
  • 10 Kosins AM, Lambros V, Daniel RK. The plunging tip: illusion and reality. Aesthet Surg J 2014; 34 (01) 45-55
    CrossrefPubMedSearch in Google Scholar
  • 11 Sadeghi M, Saedi B, Arvin Sazegar A, Amiri M. The role of columellar struts to gain and maintain tip projection and rotation: a randomized blinded trial. Am J Rhinol Allergy 2009; 23 (06) e47-e50
    CrossrefPubMedSearch in Google Scholar
  • 12 Yaberi R. et al. A comparison of the tongue-in-groove and columellar strut in creating and maintaining tip projection and rotation: a randomized single blind trial. Eur J Plast Surg 2018; 41: 293-298
    CrossrefPubMedSearch in Google Scholar
  • 13 Sazgar AK, Tavakoli K, Saedi B, Sazgar AA. Effect of septal extension graft on creating and maintaining tip rotation in tongue-in-groove technique: a case control study. Aesthetic Plast Surg 2022; 46 (01) 351-360
    CrossrefPubMedSearch in Google Scholar
  • 14 Sazgar AK, Tavakoli K, Sazgar AA, Saedi B. Effect of tongue-in-groove technique on upper lip slope in rhinoplasty. Aesthetic Plast Surg 2022; 46 (04) 1818-1827
    CrossrefPubMedSearch in Google Scholar
  • 15 Cetinkale O, Tulunay S. Augmentation of the columella-labial angle to prevent the “smiling deformity” in rhinoplasty. Aesthetic Plast Surg 1998; 22 (02) 106-110
    CrossrefPubMedSearch in Google Scholar
  • 16 Perkins K, Shah A, Patel A, Steinbacher D. The effect of nasal tip rotation on upper lip length. Aesthet Surg J 2017; 37 (05) 504-510
    PubMedSearch in Google Scholar