Modifications to the butterfly graft used to treat nasal obstruction and assessment of visibility

Myriam Loyo, Deniz Gerecci, Jess C. Mace, Melynda Barnes, Selena Liao, Tom Wang

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

IMPORTANCE: Graft visibility in the supratip region has been the main criticism of the butterfly graft. Because of the graft location, slightly unfavorable supratip fullness can occur, resulting in patient dissatisfaction with the cosmetic result. OBJECTIVE: To describe the clinical outcomes and visibility of the butterfly graft after technique modifications. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective review of adults who had undergone primary or secondary rhinoplasty with butterfly grafting from July 1, 2013, through July 31, 2014, at a tertiary care center at an academic institution, an operative log and photographs were reviewed in an effort to analyze outcomes of butterfly graft use in rhinoplasty. MAIN OUTCOMES AND MEASURES: Nasal obstruction and visibility of the butterfly graft. RESULTS: Thirty-four patients were included in the case series (mean [SD] age, 46 [19.4] years; 23 women and 11 men). The mean (SD) length of the graft was 3.4 (0.5) cm, and the mean (SD) width was 0.9 (0.2) cm. A significant decrease was found in the Nasal Obstruction Symptoms Evaluation score after surgery (mean [SD] preoperative score, 69 [17]; mean [SD] postoperative score, 23 [24]; P < .001). In regard to appearance, 25 patients (74%) rated their appearance as improved or no changes, 6 (18%) as minimally worse, and 1 (3%) as much worse. Fifty-nine observers participated in the masked survey for the study. When the graft was present, observers detected it 59.7% (282 of 472 answers) of the time. When the graft was not present, its presence was suspected 36.5% (237 of 649 answers) of the time. CONCLUSIONS AND RELEVANCE: The modified butterfly graft is a longer and thinner graft than the originally described butterfly graft. It is still an effective tool in the treatment of nasal obstruction with acceptable visibility. In most cases, it is difficult for health care professionals to identify the presence of the graft. LEVEL OF EVIDENCE: 4.

Original languageEnglish (US)
Pages (from-to)436-440
Number of pages5
JournalJAMA Facial Plastic Surgery
Volume18
Issue number6
DOIs
StatePublished - Dec 1 2016

Fingerprint

Butterflies
Nasal Obstruction
Transplants
Rhinoplasty
Symptom Assessment
Tertiary Care Centers
Cosmetics

ASJC Scopus subject areas

  • Surgery

Cite this

Modifications to the butterfly graft used to treat nasal obstruction and assessment of visibility. / Loyo, Myriam; Gerecci, Deniz; Mace, Jess C.; Barnes, Melynda; Liao, Selena; Wang, Tom.

In: JAMA Facial Plastic Surgery, Vol. 18, No. 6, 01.12.2016, p. 436-440.

Research output: Contribution to journalArticle

Loyo, Myriam ; Gerecci, Deniz ; Mace, Jess C. ; Barnes, Melynda ; Liao, Selena ; Wang, Tom. / Modifications to the butterfly graft used to treat nasal obstruction and assessment of visibility. In: JAMA Facial Plastic Surgery. 2016 ; Vol. 18, No. 6. pp. 436-440.
@article{ff95e098cf564f4fa535387fca53a42e,
title = "Modifications to the butterfly graft used to treat nasal obstruction and assessment of visibility",
abstract = "IMPORTANCE: Graft visibility in the supratip region has been the main criticism of the butterfly graft. Because of the graft location, slightly unfavorable supratip fullness can occur, resulting in patient dissatisfaction with the cosmetic result. OBJECTIVE: To describe the clinical outcomes and visibility of the butterfly graft after technique modifications. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective review of adults who had undergone primary or secondary rhinoplasty with butterfly grafting from July 1, 2013, through July 31, 2014, at a tertiary care center at an academic institution, an operative log and photographs were reviewed in an effort to analyze outcomes of butterfly graft use in rhinoplasty. MAIN OUTCOMES AND MEASURES: Nasal obstruction and visibility of the butterfly graft. RESULTS: Thirty-four patients were included in the case series (mean [SD] age, 46 [19.4] years; 23 women and 11 men). The mean (SD) length of the graft was 3.4 (0.5) cm, and the mean (SD) width was 0.9 (0.2) cm. A significant decrease was found in the Nasal Obstruction Symptoms Evaluation score after surgery (mean [SD] preoperative score, 69 [17]; mean [SD] postoperative score, 23 [24]; P < .001). In regard to appearance, 25 patients (74{\%}) rated their appearance as improved or no changes, 6 (18{\%}) as minimally worse, and 1 (3{\%}) as much worse. Fifty-nine observers participated in the masked survey for the study. When the graft was present, observers detected it 59.7{\%} (282 of 472 answers) of the time. When the graft was not present, its presence was suspected 36.5{\%} (237 of 649 answers) of the time. CONCLUSIONS AND RELEVANCE: The modified butterfly graft is a longer and thinner graft than the originally described butterfly graft. It is still an effective tool in the treatment of nasal obstruction with acceptable visibility. In most cases, it is difficult for health care professionals to identify the presence of the graft. LEVEL OF EVIDENCE: 4.",
author = "Myriam Loyo and Deniz Gerecci and Mace, {Jess C.} and Melynda Barnes and Selena Liao and Tom Wang",
year = "2016",
month = "12",
day = "1",
doi = "10.1001/jamafacial.2016.0681",
language = "English (US)",
volume = "18",
pages = "436--440",
journal = "JAMA Facial Plastic Surgery",
issn = "2168-6076",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Modifications to the butterfly graft used to treat nasal obstruction and assessment of visibility

AU - Loyo, Myriam

AU - Gerecci, Deniz

AU - Mace, Jess C.

AU - Barnes, Melynda

AU - Liao, Selena

AU - Wang, Tom

PY - 2016/12/1

Y1 - 2016/12/1

N2 - IMPORTANCE: Graft visibility in the supratip region has been the main criticism of the butterfly graft. Because of the graft location, slightly unfavorable supratip fullness can occur, resulting in patient dissatisfaction with the cosmetic result. OBJECTIVE: To describe the clinical outcomes and visibility of the butterfly graft after technique modifications. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective review of adults who had undergone primary or secondary rhinoplasty with butterfly grafting from July 1, 2013, through July 31, 2014, at a tertiary care center at an academic institution, an operative log and photographs were reviewed in an effort to analyze outcomes of butterfly graft use in rhinoplasty. MAIN OUTCOMES AND MEASURES: Nasal obstruction and visibility of the butterfly graft. RESULTS: Thirty-four patients were included in the case series (mean [SD] age, 46 [19.4] years; 23 women and 11 men). The mean (SD) length of the graft was 3.4 (0.5) cm, and the mean (SD) width was 0.9 (0.2) cm. A significant decrease was found in the Nasal Obstruction Symptoms Evaluation score after surgery (mean [SD] preoperative score, 69 [17]; mean [SD] postoperative score, 23 [24]; P < .001). In regard to appearance, 25 patients (74%) rated their appearance as improved or no changes, 6 (18%) as minimally worse, and 1 (3%) as much worse. Fifty-nine observers participated in the masked survey for the study. When the graft was present, observers detected it 59.7% (282 of 472 answers) of the time. When the graft was not present, its presence was suspected 36.5% (237 of 649 answers) of the time. CONCLUSIONS AND RELEVANCE: The modified butterfly graft is a longer and thinner graft than the originally described butterfly graft. It is still an effective tool in the treatment of nasal obstruction with acceptable visibility. In most cases, it is difficult for health care professionals to identify the presence of the graft. LEVEL OF EVIDENCE: 4.

AB - IMPORTANCE: Graft visibility in the supratip region has been the main criticism of the butterfly graft. Because of the graft location, slightly unfavorable supratip fullness can occur, resulting in patient dissatisfaction with the cosmetic result. OBJECTIVE: To describe the clinical outcomes and visibility of the butterfly graft after technique modifications. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective review of adults who had undergone primary or secondary rhinoplasty with butterfly grafting from July 1, 2013, through July 31, 2014, at a tertiary care center at an academic institution, an operative log and photographs were reviewed in an effort to analyze outcomes of butterfly graft use in rhinoplasty. MAIN OUTCOMES AND MEASURES: Nasal obstruction and visibility of the butterfly graft. RESULTS: Thirty-four patients were included in the case series (mean [SD] age, 46 [19.4] years; 23 women and 11 men). The mean (SD) length of the graft was 3.4 (0.5) cm, and the mean (SD) width was 0.9 (0.2) cm. A significant decrease was found in the Nasal Obstruction Symptoms Evaluation score after surgery (mean [SD] preoperative score, 69 [17]; mean [SD] postoperative score, 23 [24]; P < .001). In regard to appearance, 25 patients (74%) rated their appearance as improved or no changes, 6 (18%) as minimally worse, and 1 (3%) as much worse. Fifty-nine observers participated in the masked survey for the study. When the graft was present, observers detected it 59.7% (282 of 472 answers) of the time. When the graft was not present, its presence was suspected 36.5% (237 of 649 answers) of the time. CONCLUSIONS AND RELEVANCE: The modified butterfly graft is a longer and thinner graft than the originally described butterfly graft. It is still an effective tool in the treatment of nasal obstruction with acceptable visibility. In most cases, it is difficult for health care professionals to identify the presence of the graft. LEVEL OF EVIDENCE: 4.

UR - http://www.scopus.com/inward/record.url?scp=84996743356&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84996743356&partnerID=8YFLogxK

U2 - 10.1001/jamafacial.2016.0681

DO - 10.1001/jamafacial.2016.0681

M3 - Article

C2 - 27390095

AN - SCOPUS:84996743356

VL - 18

SP - 436

EP - 440

JO - JAMA Facial Plastic Surgery

JF - JAMA Facial Plastic Surgery

SN - 2168-6076

IS - 6

ER -