Evaluation of aesthetic outcomes in open technique septorhinoplasty patients

This study was carried out for comparison of pre- and post-operative facial analyses and relation between skin type and postoperative columellar scar formation in subjects operated with open technique septorhinoplasty.35 subjects were recruited from January 2007 to January 2011 in Bezmialem Vakıf Gureba Training and Research Hospital, 1. Ear-Nose Throat Clinic and Bezmialem Vakif University, Department of Otorhinolaryngology. All subjects had nasal deformities and difficulty breathing from nose. 7 (%20) of the subjects were female, 28 (%80) were male. Mean age of subjects was 31,37±10,95 years (mean±SD, 18-61). Average duration of follow up was 9,97±5,95 months (mean±SD, 6-30).Preoperative and postoperative fotogrametric facial analysis was carried out with Rhinobase software. Nasofrontal angle (NFA), nazolabial angle (NLA), tip projection and columella-lobule ratio were parameters measured for facial analysis. Measurements of male and female subjects were evaluated separately based on their normative values. Postoperative incision scars were evaluated with Stony Brook Scar Evaluation Scale and skin type was evaluated with Fitzpatrick Skin Type Classification. Relation between skin type and scar formation was analysed.Statistical analysis was carried out with NCSS (Number Cruncher Statistical System) 2007&PASS (Power Analysis and Sample Size) 2008 Statistical Software (Utah, USA). Paired Sample t test and Chi-square test was used for interpretation of data. P value of less than 0.05 was accepted as statistically significant.Postoperative measurements of NFA, NLA, tip projection and columella-lobule ratio were statistically closer to normative facial values in male subjects compared to preoperative measurements (p<0.01). Postoperative measurements were closer to normative values but significance of difference was not calculated due to limited number of female subjects.Columellar scars of all cases were evaluated based on Stony Brook Scar Scale: 3 (%8,6) cases scored 1/5; 2 (%5,7) cases scored 2/5; 4 (%11,4) cases scored 3/5; 4 (%11,4) cases scored 4/5 and 22 (% 62,9) cases scored 5/5. `inverse V? incision was used in %54,3 of the subjects (n=19); whereas %45,7 (n=16) subjects received `V? incision. All subjects were evaluated with Fitzpatrick Skin-Type Test: 2 cases were evaluated as type 2 (%5,7); 19 cases type 3 (%54,3); 14 cases type 4 (%40). Skin type and type of columellar incision were not statistically correlated with Stony Brook Scar Scale (p>0.05).Successful results with septorhinoplasty depend on scrutinized preoperative facial analysis. Preoperative analysis should be tailored for each patient?s ethnic origin and facial harmony. We believe in the utmost importance of postoperative follow up with facial analysis for evaluation of long term outcomes of different surgical techniques. Columellar scar healing results depends on careful and delicate closure of columellar incision