Download PDF
Facial Plast Surg 2016; 32(04): 398-401
DOI: 10.1055/s-0036-1585571
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pollybeak Deformity in Middle Eastern Rhinoplasty: Prevention and Treatment

Wael K.A. Hussein
1   Facial Plastic and Reconstructive Surgery Division, Department of Otorhinolaryngology, Alexandria Faculty of Medicine, Alexandria, Egypt
,
Hossam M.T. Foda
1   Facial Plastic and Reconstructive Surgery Division, Department of Otorhinolaryngology, Alexandria Faculty of Medicine, Alexandria, Egypt
› Author Affiliations
Further Information

Publication History

Publication Date:
05 August 2016 (online)

Also available at
    Permissions and Reprints

Abstract

The pollybeak deformity is one of the commonest causes of revision rhinoplasty. The Middle Eastern nose has certain criteria that predispose to the development of pollybeak deformity. The aim of this study is to detect the factors contributing to the development of pollybeak deformity in the Middle Eastern nose and methods used to prevent as well as to treat such deformity. Out of the 1,160 revision patients included in this study, 720 (62%) patients had a pollybeak deformity. The commonest contributing factors included underprojected tip with poor support in 490 (68%) patients, excessive supratip scarring in 259 (36%) patients, overresected bony dorsum in 202 (28%) patients, and high anterior septal angle in 173 (24%) patients. The methods used by the authors to treat the pollybeak deformity are described, along with the local steroid injection protocol used to guard against the recurrence of pollybeak deformity.

Keywords

rhinoplasty - tip support - pollybeak deformity - steroid injection - thick skin - revision surgery
 

  • References

  • 1 Guyuron B, DeLuca L, Lash R. Supratip deformity: a closer look. Plast Reconstr Surg 2000; 105 (3) 1140-1151 , discussion 1152–1153
    CrossrefPubMedGoogle Scholar
  • 2 Daniel RK. Middle Eastern rhinoplasty in the United States: part II. Secondary rhinoplasty. Plast Reconstr Surg 2009; 124 (5) 1640-1648
    CrossrefPubMedGoogle Scholar
  • 3 Daniel RK. Middle Eastern rhinoplasty in the United States: part I. Primary rhinoplasty. Plast Reconstr Surg 2009; 124 (5) 1630-1639
    CrossrefPubMedGoogle Scholar
  • 4 Foda HM. External rhinoplasty for the Arabian nose: a columellar scar analysis. Aesthetic Plast Surg 2004; 28 (5) 312-316
    CrossrefPubMedGoogle Scholar
  • 5 Foda HM. Management of the droopy tip: a comparison of three alar cartilage-modifying techniques. Plast Reconstr Surg 2003; 112 (5) 1408-1417 , discussion 1418–1421
    CrossrefPubMedGoogle Scholar
  • 6 Foda HM. Rhinoplasty for the multiply revised nose. Am J Otolaryngol 2005; 26 (1) 28-34
    CrossrefPubMedGoogle Scholar
  • 7 Apaydin F. Rhinoplasty in the Middle Eastern nose. Facial Plast Surg Clin North Am 2014; 22 (3) 349-355
    CrossrefPubMedGoogle Scholar
  • 8 Rohrich RJ, Ghavami A. Rhinoplasty for Middle Eastern noses. Plast Reconstr Surg 2009; 123 (4) 1343-1354
    CrossrefPubMedGoogle Scholar
  • 9 Sajjadian A. Rhinoplasty in Middle Eastern patients. Clin Plast Surg 2016; 43 (1) 281-294
    CrossrefPubMedGoogle Scholar
  • 10 Ha RY, Nojima K, Adams Jr WP, Brown SA. Analysis of facial skin thickness: defining the relative thickness index. Plast Reconstr Surg 2005; 115 (6) 1769-1773
    CrossrefPubMedGoogle Scholar
  • 11 Constantian MB. Four common anatomic variants that predispose to unfavorable rhinoplasty results: a study based on 150 consecutive secondary rhinoplasties. Plast Reconstr Surg 2000; 105 (1) 316-331 , discussion 332–333
    CrossrefPubMedGoogle Scholar
  • 12 Rettinger G. Risks and complications of rhinoplasty [in German]. Laryngorhinootologie 2007; 86 (Suppl. 01) S40-S54
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Hussein WK, El-Badan H, Sheweel Y, Bazak R. Alar lift: sail excision technique for alar overhanging in the Middle Eastern Nose. Egyptian J Ear Nose Throat Allied Science 2015; 16 (1) 13-17
    PubMedGoogle Scholar
  • 14 Bizrah MB. Rhinoplasty for Middle Eastern patients. Facial Plast Surg Clin North Am 2002; 10 (4) 381-396
    CrossrefPubMedGoogle Scholar
  • 15 Peck GC, Michelson LN. Anatomy of aesthetic surgery of the nose. Clin Plast Surg 1987; 14 (4) 737-748
    PubMedGoogle Scholar
  • 16 Gibson T, Davis B. The distortion of autogenous cartilage grafts: its cause and prevention. Br J Plast Surg 1957; 10: 257-274
    CrossrefPubMedGoogle Scholar
  • 17 Foda HM. Mersiline mesh in premaxillary augmentation. Aesthetic Plast Surg 2005; 29 (3) 169-173
    CrossrefPubMedGoogle Scholar
  • 18 Foda HM. The caudal septum replacement graft. Arch Facial Plast Surg 2008; 10 (3) 152-157
    CrossrefPubMedGoogle Scholar
  • 19 Anderson JR. Symposium: the supra-tip in rhinoplasty: a dilemma. III. Supra-tip soft-tissue rounding after rhinoplasty: causes, prevention and treatment. Laryngoscope 1976; 86 (1) 53-57
    CrossrefPubMedGoogle Scholar
  • 20 Wright WK. Symposium: the supra-tip in rhinoplasty: a dilemma. II. Influence of surrounding structure and prevention. Laryngoscope 1976; 86 (1) 50-52
    CrossrefPubMedGoogle Scholar
  • 21 Patterson CN. Symposium: the supra-tip in rhinoplasty: a dilemma. I. Theories and causes of supra-tip convexities. Laryngoscope 1976; 86 (1) 45-49
    CrossrefPubMedGoogle Scholar
  • 22 Farrior RT. Symposium: the supra-tip in rhinoplasty: a dilemma. Laryngoscope 1976; 86 (1) 43-44
    CrossrefPubMedGoogle Scholar
  • 23 Tardy Jr ME, Kron TK, Younger R, Key M. The cartilaginous pollybeak: etiology, prevention, and treatment. Facial Plast Surg 1989; 6 (2) 113-120
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Nemati S, Banan R, Alizadeh A, Leili EK, Kerdari H. Ultrasonographic evaluation of long-term results of nasal tip defatting in rhinoplasty cases. Laryngoscope 2013; 123 (9) 2131-2135
    CrossrefPubMedGoogle Scholar
  • 25 Boyadjiev C, Popchristova E, Mazgalova J. Histomorphologic changes in keloids treated with Kenacort. J Trauma 1995; 38 (2) 299-302
    CrossrefPubMedGoogle Scholar
  • 26 Trisliana Perdanasari A, Lazzeri D, Su W , et al. Recent developments in the use of intralesional injections keloid treatment. Arch Plast Surg 2014; 41 (6) 620-629
    Article in Thieme ConnectPubMedGoogle Scholar