title: Effect of the depressor septi nasi muscle modification on nasal tip rotation and projection.
abstract: BACKGROUND
  The nasal tip is an important esthetic feature of the face and surgery on it is the most challenging part of a rhinoplasty. In the present study, we evaluated the effects of modification of the depressor septi nasi muscle on nasal tip rotation and projection.
  
  
  METHODS
  Eighty primary rhinoplasty patients who required nasal tip modifications were enrolled in a randomized clinical trial from October 2008 to March 2012. A study group composed of 40 patients underwent rhinoplasty including cutting and repositioning of the depressor septi nasi muscle and another group of 40 patients (control) underwent rhinoplasty without manipulation of the depressor septi nasi muscle. Nasal tip rotation and projection, and patient satisfaction were evaluated before and 6 months after the operation.
  
  
  RESULTS
  Following rhinoplasty including cutting of the depressor septi nasi muscle, nasal tip rotation and projection, and patient satisfaction were improved in 70, 57.5, and 85 % of the patients, respectively; and in the control group, they were improved in 82.5, 55, and 67.5 %, respectively (P = 0.089, 0.607, and 0.069).
  
  
  CONCLUSIONS
  Cutting and repositioning of the depressor septi nasi muscle as an adjunct to rhinoplasty is not associated with any additional advantage in terms of nasal tip rotation and projection, or patient satisfaction.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors: Department of Otolaryngology, Imam Reza Hospital, Tabriz University (Medical Sciences), Tabriz, Iran.
authors: Javad S
authors: JS
authors: Toutounchi
authors: Sogol H
authors: SH
authors: Biroon
authors: Samira M
authors: SM
authors: Banaem
authors: Neghisa S
authors: NS
authors: Toutounchi
authors: Nariman
authors: N
authors: Nezami
authors: Behzad
authors: B
authors: Salari
mesh_terms: D000293:Adolescent; D000328:Adult; D004954:Esthetics; D005152:Facial Muscles / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009300:Nasal Septum / Q000601:surgery*; D015588:Observer Variation; D017060:Patient Satisfaction; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D012399:Rotation; D016896:Treatment Outcome; D055815:Young Adult