Role of Depressor Septi Nasi Muscle in Rhinoplasty

Fred, Gustave B.

doi:10.1001/archotol.1955.03830010039005

Cited by 10 publications

(2 citation statements)

References 2 publications

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“…The role of the depressor septi muscle in rhinoplasty has been discussed for many years. In 1955, Fred 7 postulated that maneuvers that raise the tip complex that are not accompanied by sectioning of the depressor septi result in the tip being pulled back to the position it had before it was corrected. Most of the literature regarding depressor septi interventions relates to the net effect on tip position.…”

Section: Discussionmentioning

confidence: 99%

Effect of Depressor Septi Resection in Rhinoplasty on Upper Lip Length

Deeb

Westreich

et al. 2014

JAMA Facial Plast Surg

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depressor septi in rhinoplasty has been used to correct the smiling deformity. Studying the effects of this maneuver on the upper lip length is important for operative planning, as well as for patient counseling.OBJECTIVE To define an approach to the resection of the depressor septi muscle during functional and aesthetic rhinoplasty and to determine whether performing this maneuver causes any measureable change in the length of the upper lip in the repose position. DESIGN, SETTING, AND PARTICIPANTSA retrospective medical record review and photographic analysis were performed on 36 patients who had undergone rhinoplasty involving resection of the depressor septi by either of 2 of the investigators at a tertiary care academic center and a private practice between 2010 and 2013. All maneuvers performed during the procedure were recorded. Preoperative photographs were compared with postoperative photographs using Adobe Photoshop, and percent change in upper lip length was calculated.INTERVENTION Rhinoplasty involving resection of the depressor septi. MAIN OUTCOME AND MEASUREPercent change in upper lip length, calculated by measuring the ratio between upper lip length and intercanthal distance and comparing the preoperative and postoperative ratios.RESULTS Thirty-six patients were evaluated, including 22 men and 14 women. Postoperative photographs were taken a mean (range) of 7.06 months (7 days to 2 years) after surgery. The mean change was a 1.74% decrease in upper lip length; 24 patients (67%) had a decrease (mean [maximum], 5.89% [21.22%]), and 12 patients (33%), an increase (mean [maximum], 6.55% [12.68%]) in upper lip length. Compared with the preoperative lip length, the mean (95% CI) postoperative lip length was 100.09% (97.35%-102.83%) in women vs 95.37% (90.86%-99.88%) in men (P = .07). No predictable factors determined whether a patient would develop a postoperative increase or decrease in upper lip length.CONCLUSIONS AND RELEVANCE Resection of the depressor septi muscle during rhinoplasty is a well-documented maneuver often used in the treatment of the ptotic tip and smile deformity. This descriptive study showed that resection of the depressor septi muscle has an unpredictable but small effect on upper lip length in the repose position.LEVEL OF EVIDENCE 3.

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Section: Discussionmentioning

confidence: 99%

Effect of Depressor Septi Resection in Rhinoplasty on Upper Lip Length

Deeb

Westreich

et al. 2014

JAMA Facial Plast Surg

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“…Treatment of the smile deformity can be accomplished in a variety of ways. [35][36][37][38] All interventions focus on alteration of the depressor septi nasi muscle. The depressor septi is a paired muscle contained within the columella, which originates on the medial crura footplates and caudal septum and has variable insertion patterns in the region of the orbicularis oris and nasal spine.…”

Section: Nasal Tip Surgerymentioning

confidence: 99%

Ethnically Sensitive Rhinoplasty

Deeb¹

2023

Facial Plast Surg

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Ethnically sensitive rhinoplasty presents a unique challenge. There are a large number of variations of skin tone, skin thickness and structural deformities, which require a high degree of thoughtfulness and planning. A thorough history and physical examination is the cornerstone to achieving a good result. An open and honest discussion is necessary to fully understand the patient’s goals. The surgeon should clearly define which goals are achievable and which are not. An individualized approach with special consideration towards maintaining ethnic heritage is imperative. Conservative techniques will help achieve a natural, balanced outcome and will allow for preservation of nasal function.

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