Columella retraction suture may be a safe and effective method for controlling dead space after correcting the nasolabial and columella-tip complex, according to recent findings.
The researchers suggested that the choice to use a columella retraction suture comes after all incisions used for endonasal or open approach rhinoplasty have been closed. Clinicians should use palpation of the columella with a blunt instrument to determine the existence of dead space, accounting for double break and nasolabial angle. The space should be marked with ink. For the next step, “A Vicryl 4-0 with straight SC1 needle is entered from the vestibular side, cephalic to the footplate when no narrowing of the columella is needed, or through the footplate when the surgeon feels the need to bring the footplates closer together,” according to the findings.
The ink mark is the location of the exit. Clinicians should then use the same hole for re-entry — which allows the suture to exist beneath the skin — and then push the needle out on the vestibular side. The needle should then be passed through the septum at a distance of 2 mm to 3 mm more cephalic from one vestibulum to the other, according to the results.
When the suture is tied, there will be a dimple below the skin that should disappear within a few weeks.
Experts have used this technique in 200 cases, with one superficial infection in the columella as the only complication. – by Rob Volansky
Disclosure: The researchers report no relevant financial disclosures.