title: Anatomic basis of notch deformity in open rhinoplasty.
abstract: Notch deformity at the columella after the stairstep incision is an unsightly sequel that fuels negativism for open rhinoplasty critics. Obvious causes cited include surgical misadventures involving division of the foot of the medial crus and poor healing. The authors offer yet an additional etiology based on the contraction distortion caused by the depressor septi nasi muscle. The purpose of this study is to investigate the anatomic basis for notch deformity after stairstep technique in open rhinoplasty. For this anatomic study, 10 fresh cadavers were used. Dissections were performed, exposing the columellar components. The macroscopic and microscopic photo documentation gathered supports the authors' theory that depressor septi nasi action causes skin-edge deformation that leads to closure malalignment and notch deformity. Pre-incision landmark defining tattoo or sutures will assure proper alignment at closure.
authors.affiliation: Section of Plastic Surgery, Medical College of Georgia, Augusta, GA 30912, USA. Mabel_Gamboa@hotmail.com
authors.forename: Mabel
authors.initials: M
authors.lastname: Gamboa
authors.forename: Paul
authors.initials: P
authors.lastname: Shayani
authors.forename: Robert
authors.initials: R
authors.lastname: Schmid
authors.forename: Ever
authors.initials: E
authors.lastname: Bobadilla
authors.forename: Steven
authors.initials: S
authors.lastname: Blackwell
mesh_terms: D002102:Cadaver; D004210:Dissection; D005152:Facial Muscles / Q000033:anatomy & histology* / Q000503:physiopathology; D006801:Humans; D009119:Muscle Contraction / Q000502:physiology; D009666:Nose / Q000033:anatomy & histology*; D009667:Nose Deformities, Acquired / Q000209:etiology*; D012225:Rhinoplasty / Q000009:adverse effects*