Outcome Evaluation of Various Surgical Techniques in Nasal Tip Plasty via Open Rhinoplasty Approach

Abstract

Background: Nasal tip management is the key component of successful rhinoplasty, emphasizing refinement, narrowing, rotation, and projection of the nasal tip structure. Many techniques rely on precise suture placement and tension control to achieve a natural-appearing nasal tip contour. Objectives: To determine patient satisfaction subjectively after tip plasty using open rhinoplasty, and to observe and measure objective changes in aesthetic factors of nasal tip definition, rotation, and projection. Patients and Methods: A case series study was conducted in the ENT Department at Al-Shaheed Gazi Al-Hariri Hospital for Surgical Specialties, Medical City, Baghdad, between October 2015 and October 2016. Thirty patients (14 males, 16 females) underwent open tip plasty. Preoperative and postoperative (6-month) assessments employed the Rhinoplasty Outcome Evaluation (ROE) questionnaire for subjective evaluation, and standardized photographic analysis with AutoCAD 2007 measurements for objective assessment of tip definition, nasolabial angle, and projection using Goode&#39;s method. Results: The mean ROE satisfaction score improved significantly from 43.61% preoperatively to 73.19% postoperatively (p < 0.05). Tip definition improved in 80% of patients, nasal tip rotation in 78%, and projection in 33.3%. Complications were minimal: polybeak deformity in 2 patients (6.6%), persistent nasal obstruction in 3 patients (10%), and one case of scar hypertrophy (3.3%). Conclusion: Open rhinoplasty with combined conservative surgical techniques including suturing, cephalic trimming, columellar strut, and tip grafts achieves good patient satisfaction with favorable results in tip definition and rotation. Tip projection remains the most challenging parameter to correct and may require additional or complementary techniques.