Summary: In this article, the author describes a new closed rhinoplasty technique in which the Pitanguy ligament was protected, ultimately resulting in better supratip break, tip projection, and tip rotation. Based on the inclusion and exclusion criteria, the records of 156 patients who underwent surgery with this "Pitanguy ligament protection and suturing" technique were evaluated retrospectively. In this novel technique, the Pitanguy ligament was dissected from the proximal and distal points with scissors in the lower third, and it was left intact. There was no need for revision operations in any patient. Twelve months after surgery, the Rhinoplasty Outcome Evaluation scores ranged between 80 and 100 points. The median score was 86.5 points. Patient satisfaction was excellent in 90% of the included cases. Protection of the Pitanguy ligament and attachment of this ligament to the nasal tip create better tip definition and generate several aesthetic and functional advantages.

Clinical Question/level Of Evidence: Therapeutic, IV.

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http://dx.doi.org/10.1097/PRS.0000000000010468DOI Listing

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Article Synopsis
  • The text discusses new challenges in achieving a stable supratip break during rhinoplasty, particularly in patients with thicker skin, highlighting the limitations of previous techniques used to address this issue.* -
  • A novel method introduced by the senior author involves utilizing the native Pitanguy ligament along with two bilateral SMAS flaps, which helps control supratip shape and reduces dead space, leading to improved outcomes post-surgery.* -
  • Results from 26 patients show that this technique maintained varying degrees of supratip break after an average follow-up of 14 months, with no significant complications reported, indicating its effectiveness and stability.*
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The Pitanguy ligament is a crucial structure in nasal tip support and in maintaining the integrity of the soft tissue envelope of the nose. In this cadaveric study, we dissected out the Pitanguy ligament on a series of fresh human cadaver specimens to better elucidate the structure of the ligament and its fate in open rhinoplasty. The Pitanguy ligament can act as a tethering force to the nasal tip when reshaping the nasal tip.

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Introduction: In the preservation rhinoplasty era, ligament management represents a hot topic. The aim of this study is to analyze the role of ligaments as indispensable elements of support of the nasal tip to have an adequate, safe, and predictable aesthetic and functional result.

Material And Methods: Patients meeting the following criteria were included in the study: primary rhinoplasty, minimum 2-year follow-up, proficiency in Italian language, signed consent, and standardized pre- and postoperative photographic documentation.

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Summary: In this article, the author describes a new closed rhinoplasty technique in which the Pitanguy ligament was protected, ultimately resulting in better supratip break, tip projection, and tip rotation. Based on the inclusion and exclusion criteria, the records of 156 patients who underwent surgery with this "Pitanguy ligament protection and suturing" technique were evaluated retrospectively. In this novel technique, the Pitanguy ligament was dissected from the proximal and distal points with scissors in the lower third, and it was left intact.

View Article and Find Full Text PDF

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