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The Role of Skin Thickness in the Choice of a Rhinoplasty Technique for Thin-Skinned Patients: Analysis of Long-Term Results and Patient Satisfaction

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  • Rhinoplasty
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A Correction to this article was published on 08 June 2020

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Abstract

Introduction

This randomized controlled study aimed to analyse the long-term results of thin-skinned patients who underwent rhinoplasty.

Materials and Methods

All the included study patients had the following characteristics: underwent primary rhinoplasty for functional and/or cosmetic problems, were thin-skinned, had been followed for almost 2 years, underwent both standard pre- and post-operative photography, had a good understanding of the Italian language, and had signed a consent form for inclusion in the study. The patients were randomly divided into 4 groups as follows: group 1, camouflage of the dorsum by diced cartilage; group 2, camouflage of the dorsum with lipofilling; group 3, camouflage of the dorsum by a temporal fascia graft; and group 4 (control group), without camouflage of the dorsum. Patients answered the Italian version of the FACE-Q rhinoplasty module. The Obagi skin pinch test was used to measure nasal skin thickness. We compared pre- and post-operative patient satisfaction with the appearance of their nose between the 4 patient groups by the Chi-squared test for unpaired data. Two plastic surgeons reviewed all the post-operative photographs of the study patients and rated the photographs on a scale of 1 to 5.

Results

A total of 101 patients who underwent primary rhinoplasty between January 2016 and March 2018 in our department of plastic surgery and satisfied the inclusion criteria were enrolled in this study. The mean patient age was 38.5 years. The mean follow-up time was 2.5 years. The differences between the preoperative and post-operative FACE-Q values for group 1 were significant (P < 0.01), whereas the differences between the preoperative and post-operative FACE-Q values for the other groups were not significant. The results for group 1 patients remained stable over the long-term follow-up compared with the results for other groups (P < 0.01). Groups 2 and 4 underwent more secondary procedures than groups 1 and 3 (P < 0.01). The 2 reviewers determined that patient groups 1 and 3 obtained more satisfactory outcomes than groups 1 and 4 (P < 0.01).

Conclusions

This was the first randomized study to demonstrate that diced cartilage grafts used for thin-skinned patients was the best approach for obtaining a satisfactory long-term outcome and durable natural appearance.

Level of Evidence I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Change history

  • 08 June 2020

    The authors of this article wish to make the following clarification: The FACE-Q is a trademarked patient reported outcome instrument. The “Satisfaction with Nose” scale described and reproduced in this article is similarly trademarked; the copyright is retained by the Q-Portfolio. If readers would like to use the FACE-Q in research or clinical practice, they are directed to www.qportfolio.org to obtain a license permission from the copyright holders. Reproduction of the FACE-Q in publications without prior permission is not permitted.

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Authors and Affiliations

  1. Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University of Rome, Via Alvaro Del Portillo 200, Rome, Italy

    Mauro Barone, Annalisa Cogliandro, Rosa Salzillo, Silvia Ciarrocchi, Vincenzo Panasiti, Rosa Coppola, Vito Russo, Stefania Tenna & Paolo Persichetti

  2. Research Group “To be and to appear: Objective Indication to Plastic Surgery” of Campus Bio-Medico University in Rome, Rome, Italy

    Mauro Barone, Annalisa Cogliandro & Paolo Persichetti

  3. Institute of Philosophy of Scientific and Technological Activity, Campus Bio-Medico University of Rome, Rome, Italy

    Mauro Barone

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  1. Mauro Barone
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Correspondence to Mauro Barone.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent related to the photography was required of every study patient, which included permission for publication.

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Barone, M., Cogliandro, A., Salzillo, R. et al. The Role of Skin Thickness in the Choice of a Rhinoplasty Technique for Thin-Skinned Patients: Analysis of Long-Term Results and Patient Satisfaction. Aesth Plast Surg 44, 1742–1750 (2020). https://doi.org/10.1007/s00266-020-01763-6

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