Abstract
Background
Supratip deformity, also known as pollybeak deformity, is a common complication of primary and secondary rhinoplasty, characterized by fullness in the supratip region. The correction of pollybeak deformity is a challenging procedure, and its management requires a thorough understanding of the pathogenic mechanism of pollybeak deformity.
Objectives
This study aimed to evaluate the effectiveness of surgical methods for correcting pollybeak deformity in Asian rhinoplasty.
Methods
A retrospective chart review was conducted for 53 patients who underwent pollybeak correction between 2021 and 2022. A modified classification system for pollybeak deformity, the Supratip Fullness Rating Scale (SFRS), was developed to evaluate supratip fullness. The aesthetic outcomes of the patients were assessed by surgeons using the visual analog scale (VAS), and patient was self-assessed using the Rhinoplasty Outcome Evaluation (ROE) scale.
Results
The study demonstrated that our surgical method resulted in satisfactory outcomes, with a mean SFRS score change from 2.34[0.65] to 0.23[0.42], a decrease in VAS score from 7.47[1.73] to 1.79[1.67] and a high satisfaction rate of 77.36%, calculated by ROE score. No complications were reported.
Conclusion
Our surgical method for correcting pollybeak deformity in Asian rhinoplasty can result in satisfactory outcomes, particularly in terms of aesthetic appearance, without any side effects. The use of the modified classification system (SFRS) can provide an objective evaluation of supratip fullness, thereby aiding in the management of this challenging complication.
Level of Evidence IV
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References
Guyuron B, DeLuca L, Lash R (2000) Supratip deformity: a closer look. Plast Reconstr Surg 105:1140–1151. https://doi.org/10.1097/00006534-200003000-00049
Rohrich RJ, Shanmugakrishnan RR, Mohan R (2020) Rhinoplasty refinements: addressing the pollybeak deformity. Plast Reconstr Surg 145:696–699. https://doi.org/10.1097/PRS.0000000000006613
Bermudez P, Quereshy FA (2021) Nasal tip deformities after primary rhinoplasty. Oral Maxillofac Surg Clin N Am 33:111–117. https://doi.org/10.1016/j.coms.2020.09.005
Kucukguven A, Konas E (2022) Fine-tuning of the supratip in rhinoplasty: an external approach. Aesthet Plast Surg 46:2938–2946. https://doi.org/10.1007/s00266-022-03067-3
Hussein WKA, Foda HMT (2016) Pollybeak deformity in middle eastern rhinoplasty: prevention and treatment. Facial Plast Surg FPS 32:398–401. https://doi.org/10.1055/s-0036-1585571
Kim S-K, Kim J-C, Lee K-C, Kim H-S (2012) Correction of the supratip deformity of the nose. Aesthet Surg J 32:943–955. https://doi.org/10.1177/1090820X12463386
Aires MM, de Vasconcelos D, de Moraes BT (2020) Chondrolaryngoplasty in transgender women: Prospective analysis of voice and aesthetic satisfaction. Int J Transgender Health 69:1–9. https://doi.org/10.1080/26895269.2020.1848690
Gong X, Yuan M, Gu C et al (2023) Effects of dose and injection site on gingival smile treatment with botulinum toxin type A: a prospective study. Plast Reconstr Surg 151:56e–67e. https://doi.org/10.1097/PRS.0000000000009799
Cobo R (2008) Correction of dorsal abnormalities in revision rhinoplasty. Facial Plast Surg FPS 24:327–338. https://doi.org/10.1055/s-0028-1083086
Hoehne J, Brandstetter M, Gubisch W, Haack S (2019) How to reduce the probability of a pollybeak deformity in primary rhinoplasty: a single-center experience. Plast Reconstr Surg 143:1620–1624. https://doi.org/10.1097/PRS.0000000000005653
Hanasono MM, Kridel RWH, Pastorek NJ et al (2002) Correction of the soft tissue pollybeak using triamcinolone injection. Arch Facial Plast Surg 4:26–30. https://doi.org/10.1001/archfaci.4.1.26
Erdal AI, Genç İG (2022) Transection of pitanguy’s midline ligament to avoid supratip depression in closed-approach low-septal-resection dorsal preservation rhinoplasty. Aesthet Surg J 93:211. https://doi.org/10.1093/asj/sjac211
Alsarraf R (2000) Outcomes research in facial plastic surgery: a review and new directions. Aesthet Plast Surg 24:192–197. https://doi.org/10.1007/s002660010031
Alsarraf R, Larrabee WF, Anderson S et al (2001) Measuring cosmetic facial plastic surgery outcomes: a pilot study. Arch Facial Plast Surg 3:198–201. https://doi.org/10.1001/archfaci.3.3.198
Sazgar AA, Razmara N, Razfar A et al (2019) Outcome of rhinoplasty in patients undergoing autospreader flaps without notable dorsal hump reduction: a clinical trial. J Plast Reconstr Aesthet Surg JPRAS 72:1688–1693. https://doi.org/10.1016/j.bjps.2019.06.022
Vandenbroucke JP (2007) Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Ann Intern Med 147:4562. https://doi.org/10.7326/0003-4819-147-8-200710160-00010-w1
Parkes ML, Kanodia R, Machida BK (1992) Revision rhinoplasty. an analysis of aesthetic deformities. Arch Otolaryngol Head Neck Surg 118:695–701. https://doi.org/10.1001/archotol.1992.01880070025005
O’connor GB, McGregor MW (1946) Secondary rhinoplasties: their cause and prevention. Plast Reconstr Surg 15:404–410
Rohrich RJ, Ghavami A (2009) Rhinoplasty for middle Eastern noses. Plast Reconstr Surg 123:1343–1354. https://doi.org/10.1097/PRS.0b013e31817741b4
Daniel RK (2009) Middle Eastern rhinoplasty in the United States: Part I primary rhinoplasty. Plast Reconstr Surg 124:1630–1639. https://doi.org/10.1097/PRS.0b013e3181babc95
Daniel RK (2009) Middle Eastern rhinoplasty in the United States: Part II secondary rhinoplasty. Plast Reconstr Surg 124:1640–1648. https://doi.org/10.1097/PRS.0b013e3181babcd1
Foda HMT (2003) Management of the droopy tip: a comparison of three alar cartilage-modifying techniques. Plast Reconstr Surg 112:1408–1417. https://doi.org/10.1097/01.PRS.0000081065.48569.43
Vuyk HD, Watts SJ, Vindayak B (2000) Revision rhinoplasty: review of deformities, aetiology and treatment strategies. Clin Otolaryngol Allied Sci 25:476–481. https://doi.org/10.1046/j.1365-2273.2000.00353.x
Lan MY, Jang YJ (2015) Revision rhinoplasty for short noses in the Asian population. JAMA Facial Plast Surg 17:325–332. https://doi.org/10.1001/jamafacial.2015.0645
Slupchynskyj O, Rahimi M (2014) Revision rhinoplasty in ethnic patients: pollybeak deformity and persistent bulbous tip. Facial Plast Surg FPS 30:477–484. https://doi.org/10.1055/s-0034-1367715
Campus GV, Farace F, Rubino C, Sanna MPG (2007) A technical refinement to prevent supratip deformity in aesthetic rhinoplasty: “the trapezoid peak.” Aesthet Plast Surg 31:88–93. https://doi.org/10.1007/s00266-006-0153-1
Gunter JP, Rohrich RJ (1987) External approach for secondary rhinoplasty. Plast Reconstr Surg 80:161–174. https://doi.org/10.1097/00006534-198708000-00001
Gruber RP, Melkun ET, Woodward JF, Perkins SW (2011) Dorsal reduction and spreader flaps. Aesthet Surg J 31:456–464. https://doi.org/10.1177/1090820X11404401
Boccieri A (2005) Mini spreader grafts: a new technique associated with reshaping of the nasal tip. Plast Reconstr Surg 116:1525–1534. https://doi.org/10.1097/01.prs.0000182787.99210.10
Pshenisnov KP, Pshenisnov KK (2021) Invited discussion on: M-shaped auricular cartilage as modified septal extension graft: a study by three-dimensional anthropometric analysis in Asian rhinoplasty. Aesthet Plast Surg 45:2295–2299. https://doi.org/10.1007/s00266-021-02278-4
Wang D, Hou K, Zeng N (2021) M-shaped auricular cartilage as modified septal extension graft: a study by three-dimensional anthropometric analysis in asian rhinoplasty. Aesthet Plast Surg 45:2287–2294. https://doi.org/10.1007/s00266-021-02217-3
Guyuron B, Lee M (2017) An effective algorithm for management of noses with thick skin. Aesthet Plast Surg 41:381–387. https://doi.org/10.1007/s00266-017-0779-1
Jung D-H, Lin RY-C, Jang H-J et al (2009) Correction of pollybeak and dimpling deformities of the nasal tip in the contracted, short nose by the use of a supratip transposition flap. Arch Facial Plast Surg 11:311–319. https://doi.org/10.1001/archfacial.2009.60
Funding
This work was supported by the Hunan Provincial Natural Science Foundation (No.2021JJ30034).
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Xiancheng Wang and Hongli Zhao is the first co-author.
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Supplementary video 1. Supratip suture (MP4 51012 kb)
Supplementary video 2. Supratip skin excision (MP4 88083 kb)
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Wang, X., Zhao, H., Sun, Y. et al. A New Classification of Pollybeak Deformity and Its Treatment in Asian Rhinoplasty. Aesth Plast Surg 48, 388–397 (2024). https://doi.org/10.1007/s00266-023-03695-3
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DOI: https://doi.org/10.1007/s00266-023-03695-3