Open Rhinoplasty: Influence of Incisions, Alar Resection, and Columellar Strut on Final Appearance of the Tip

The aim of this study is to analyze scientifically the results of a rhinoplasty is a difficult task because of the multiplicity of surgical procedures and the subjective nature of the nose's beauty. Nevertheless, we wanted to evaluate open rhinoplasty by relying on objective and subjective criteria. From 2004 to 2011, a total of 155 patients underwent open septorhinoplasty at our hospital. After excluding patients lost to follow-up and those who underwent orthognathic surgery, 55 patients were included in the study. The evaluation was based on the clinical record, the standardized photographs, and the consultation of control. We studied in particular the nasolabial angle (NLA), the Goode ratio (projection/length of nose), and patient satisfaction using the rhinoplasty outcome evaluation form. The columella-transalar incision tended to close the NLA (p = 0.001) and lowered the Goode ratio (p = 0.01), in contrast to the R,thi incision. The resection of the alar cartilages logically induced closure of the NLA (p = 0.02) and a decrease of nose projection (p = 0.001), whereas the use of a columellar strut induced a projection increase (p = 0.01). Despite the existence of unavoidable measures bias, we confirmed a number of assumptions that had never been demonstrated statistically. Furthermore, we found that the incision used could affect the final result of a rhinoplasty.