Nasal tip bossae in rhinoplasty. Etiology, predisposing factors, and management techniques.

G. S. Gillman, R. L. Simons, David J Lee

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVES: To identify preoperative risk factors and surgical techniques that influence the risk of developing postoperative nasal tip bossae in rhinoplasty. A secondary objective was to review the characteristics, management techniques, and outcomes of those study patients with postoperative bossae. DESIGN: Univariate and multivariate analysis carried out in a case series. SETTING: Private facial plastic surgery practice. PATIENTS: All patients who underwent aesthetic nasal surgery that included surgical modification of the nasal tip, and in whom documentation was complete and photographic follow-up was available, were considered eligible. The study group consisted of 875 patients of whom 37 (4.2%) developed bossae postoperatively. MAIN OUTCOME MEASURES: Potential risk factors for postoperative bossae included age, sex, previous nasal surgery, preoperative tip asymmetry, preoperative lobular bifidity, preoperative bossae, skin thickness, surgical tip technique, use of columellar struts, columellar battens, lobular crushed cartilage grafts, and tip shield grafts. RESULTS: In the univariate analysis, females, patients undergoing primary rhinoplasty, younger age groups (12- to 22-year-olds), thin skin, and widened interdomal distance (bifidity) were all noted to have moderate or strong associations with nasal tip bossae. In the multivariate analysis, the younger age group, thin skin, and bifidity were statistically significant and independently associated with nasal tip bossae, independent of the type of tip surgery. In addition, clinically relevant associations were noted in females and patients undergoing primary rhinoplasty. Recognition of risk factors, preventive measures, and treatment methods is recommended.

Fingerprint

Rhinoplasty
Nose
Causality
Nasal Surgical Procedures
Plastic Surgery
Skin
Multivariate Analysis
Age Groups
Transplants
Documentation
Cartilage
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Surgery

Cite this

@article{6f150b22287a4c55adf7bf0cf9c60400,
title = "Nasal tip bossae in rhinoplasty. Etiology, predisposing factors, and management techniques.",
abstract = "OBJECTIVES: To identify preoperative risk factors and surgical techniques that influence the risk of developing postoperative nasal tip bossae in rhinoplasty. A secondary objective was to review the characteristics, management techniques, and outcomes of those study patients with postoperative bossae. DESIGN: Univariate and multivariate analysis carried out in a case series. SETTING: Private facial plastic surgery practice. PATIENTS: All patients who underwent aesthetic nasal surgery that included surgical modification of the nasal tip, and in whom documentation was complete and photographic follow-up was available, were considered eligible. The study group consisted of 875 patients of whom 37 (4.2{\%}) developed bossae postoperatively. MAIN OUTCOME MEASURES: Potential risk factors for postoperative bossae included age, sex, previous nasal surgery, preoperative tip asymmetry, preoperative lobular bifidity, preoperative bossae, skin thickness, surgical tip technique, use of columellar struts, columellar battens, lobular crushed cartilage grafts, and tip shield grafts. RESULTS: In the univariate analysis, females, patients undergoing primary rhinoplasty, younger age groups (12- to 22-year-olds), thin skin, and widened interdomal distance (bifidity) were all noted to have moderate or strong associations with nasal tip bossae. In the multivariate analysis, the younger age group, thin skin, and bifidity were statistically significant and independently associated with nasal tip bossae, independent of the type of tip surgery. In addition, clinically relevant associations were noted in females and patients undergoing primary rhinoplasty. Recognition of risk factors, preventive measures, and treatment methods is recommended.",
author = "Gillman, {G. S.} and Simons, {R. L.} and Lee, {David J}",
year = "1999",
month = "4",
day = "1",
language = "English",
volume = "1",
pages = "83--89",
journal = "JAMA Facial Plastic Surgery",
issn = "2168-6076",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Nasal tip bossae in rhinoplasty. Etiology, predisposing factors, and management techniques.

AU - Gillman, G. S.

AU - Simons, R. L.

AU - Lee, David J

PY - 1999/4/1

Y1 - 1999/4/1

N2 - OBJECTIVES: To identify preoperative risk factors and surgical techniques that influence the risk of developing postoperative nasal tip bossae in rhinoplasty. A secondary objective was to review the characteristics, management techniques, and outcomes of those study patients with postoperative bossae. DESIGN: Univariate and multivariate analysis carried out in a case series. SETTING: Private facial plastic surgery practice. PATIENTS: All patients who underwent aesthetic nasal surgery that included surgical modification of the nasal tip, and in whom documentation was complete and photographic follow-up was available, were considered eligible. The study group consisted of 875 patients of whom 37 (4.2%) developed bossae postoperatively. MAIN OUTCOME MEASURES: Potential risk factors for postoperative bossae included age, sex, previous nasal surgery, preoperative tip asymmetry, preoperative lobular bifidity, preoperative bossae, skin thickness, surgical tip technique, use of columellar struts, columellar battens, lobular crushed cartilage grafts, and tip shield grafts. RESULTS: In the univariate analysis, females, patients undergoing primary rhinoplasty, younger age groups (12- to 22-year-olds), thin skin, and widened interdomal distance (bifidity) were all noted to have moderate or strong associations with nasal tip bossae. In the multivariate analysis, the younger age group, thin skin, and bifidity were statistically significant and independently associated with nasal tip bossae, independent of the type of tip surgery. In addition, clinically relevant associations were noted in females and patients undergoing primary rhinoplasty. Recognition of risk factors, preventive measures, and treatment methods is recommended.

AB - OBJECTIVES: To identify preoperative risk factors and surgical techniques that influence the risk of developing postoperative nasal tip bossae in rhinoplasty. A secondary objective was to review the characteristics, management techniques, and outcomes of those study patients with postoperative bossae. DESIGN: Univariate and multivariate analysis carried out in a case series. SETTING: Private facial plastic surgery practice. PATIENTS: All patients who underwent aesthetic nasal surgery that included surgical modification of the nasal tip, and in whom documentation was complete and photographic follow-up was available, were considered eligible. The study group consisted of 875 patients of whom 37 (4.2%) developed bossae postoperatively. MAIN OUTCOME MEASURES: Potential risk factors for postoperative bossae included age, sex, previous nasal surgery, preoperative tip asymmetry, preoperative lobular bifidity, preoperative bossae, skin thickness, surgical tip technique, use of columellar struts, columellar battens, lobular crushed cartilage grafts, and tip shield grafts. RESULTS: In the univariate analysis, females, patients undergoing primary rhinoplasty, younger age groups (12- to 22-year-olds), thin skin, and widened interdomal distance (bifidity) were all noted to have moderate or strong associations with nasal tip bossae. In the multivariate analysis, the younger age group, thin skin, and bifidity were statistically significant and independently associated with nasal tip bossae, independent of the type of tip surgery. In addition, clinically relevant associations were noted in females and patients undergoing primary rhinoplasty. Recognition of risk factors, preventive measures, and treatment methods is recommended.

UR - http://www.scopus.com/inward/record.url?scp=0033107695&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033107695&partnerID=8YFLogxK

M3 - Article

C2 - 10937083

AN - SCOPUS:0033107695

VL - 1

SP - 83

EP - 89

JO - JAMA Facial Plastic Surgery

JF - JAMA Facial Plastic Surgery

SN - 2168-6076

IS - 2

ER -