New Suturing Approaches for Patients with Nasal Hump and Septal Deviation

ANNALS OF PLASTIC SURGERY(2022)

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Abstract
Rhinoplasty is one of the most common applied aesthetic surgery procedures worldwide. Dorsal hump deformity is common in western countries due to nasal profile of Whites. Septal deviation deformity is another common problem among patients who goes through aesthetic and plastic surgery. The estimated rate of septal deviation was reported to be 77% to 90% in the general population. The patients who had dorsal hump and septal deviation simultaneously are considered to be challenging for surgeons. In this research, the author presents new suturing approaches, which would be beneficial in dorsal preservation techniques in terms of fixing the septal deviation. One hundred and seventeen patients met the inclusion and exclusion criteria, and their records were assessed retrospectively. The patients who underwent either push-down and let-down techniques or septorhinoplasty were applied "8" shaped or loop suturing approaches. In addition, 33 patients with the same inclusion and exclusion criteria in whom classical loop suturing technique was used were included in the study. The Rhinoplasty Outcome Evaluation scores ranged between 80 and 100 points after 1 year. The initial median Rhinoplasty Outcome Evaluation score was 52.5, and it increased to 91.00 points at 12 months after surgery (P < 0.001). Patient satisfaction was excellent in 92.68% of the study group, and it was 72.72% in the control group. Excellent satisfaction rate was higher in the study group (P = 0.01). This study is the first to demonstrate the beneficial effects of loop and "8"-shaped sutures in patients who had nasal hump and septal deviation deformities. These suturing approaches will allow better long-term outcomes.
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Key words
deviation, suturing, preservation rhinoplasty, let down, push down
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