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 D.
N1 - Publisher Copyright:
Copyright 2016 American Medical Association. All rights reserved.
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.
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U2 - 10.1001/jamafacial.2016.0681
DO - 10.1001/jamafacial.2016.0681
M3 - Article
C2 - 27390095
AN - SCOPUS:84996743356
SN - 2168-6076
VL - 18
SP - 436
EP - 440
JO - JAMA Facial Plastic Surgery
JF - JAMA Facial Plastic Surgery
IS - 6
ER -