The Influence of the Pitanguy Ligament on the Supratip Break Point in Open Rhinoplasty.

Background: The supratip break point is paramount in nasal aesthetics. "Pollybeak deformity" denotes a swollen supratip, posing aesthetic concerns. The Pitanguy ligament facilitates tissue attachment and aids in the control of fibrosis. This study investigated the impact of Pitanguy ligament repair on the supratip depth.

Methods: This retrospective study conducted between May of 2019 and July of 2023 included 120 patients divided into 3 groups, each comprising 40 patients: group 1 (no-touch group), the Pitanguy ligament remained untouched; group 2 (excision group), the Pitanguy ligament was excised; and group 3 (repair group), the Pitanguy ligament was sutured to the highest point of the caudal septum. Patient photographs were taken at 3 and 12 months postoperatively. Supratip area depth was measured using Adobe Photoshop software. Changes in the supratip break point depth at 3 and 12 months, along with a comparison of the 12-month supratip depths among the groups, were conducted.

Results: The study included 120 patients (96 women and 24 men). Group 2 exhibited statistically significant differences when comparing the changes between 3 and 12 months postoperatively ( P < 0.05). By month 12, the depth of the repair group (group 3) significantly exceeded that of the other groups ( P < 0.05).

Conclusion: This study demonstrates that performing Pitanguy repair in open rhinoplasty techniques significantly enhances supratip depth and prevents pollybeak deformities.

Clinical question/level of evidence: Therapeutic, III.