Preoperative classification of rhinoplasty
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Classification of Soft Tissue Thickness in Rhinoplasty and its Importance in the Prevention of Postoperative Irregularities
In the world of plastic surgery, rhinoplasty remains one of the most demanded procedures. However, one of the recurring concerns following this intervention is irregularities in the nasal dorsum, especially in patients with thin skin. To address this problem, a recent study published by Garcia Ceballos in Cirugía Plástica Ibero-Latinoamericana – Vol. 50, Nº 4 – 2024 has proposed a classification of the thickness of the soft tissue of the nasal dorsum, in order to optimize aesthetic results and reduce complications.
Importance of Soft Tissue Thickness in Rhinoplasty
The skin of the nasal dorsum acts as a covering that may soften or highlight underlying structures. In patients with very thin skin, small bony or cartilaginous irregularities may become visible, while in those with thick skin, structural definition may be compromised. Evaluation of soft tissue thickness prior to surgery allows problems to be anticipated and preventive measures to be implemented.
Nasal Dorsal Soft Tissue Thickness Rating (R-STET)
This classification is based on the preoperative measurement of soft tissue thickness at the level of the rhinion (R-STET: Rhinion Soft Tissue Envelope Thickness). Patients are divided into two main categories:
Type I – Thin skin (< 3mm thick)
These patients are at an increased risk of developing visible irregularities after surgery. To minimize this problem, intraoperative treatment is recommended that includes:
- Application of subcutaneous clot of L-PRF (platelet- and leukocyte-rich fibrin), which promotes tissue regeneration and improves skin quality.
- Intradermal grafting of L-PRF-enrichednanofat, which increases the thickness of the soft tissue and conceals irregularities.
Type II – Normal or thick skin (≥ 3mm thick).
In these cases, the soft tissue is sufficient to cover possible irregularities of the nasal skeleton. However, to prevent excessive swelling of the nasal tip, it is recommended:
- Intraoperative intradermal steroid application, which reduces fibrosis and optimizes postoperative evolution.
Benefits of this Classification
Thanks to this methodology, surgeons can customize intraoperative and postoperative treatments according to individual patient characteristics. This allows:
- To reduce the incidence of postoperative irregularities in aesthetic rhinoplasty.
- Optimize the quality of long-term results.
- Decrease the need for subsequent surgical touch-ups.
At MMG Plastic Surgery we care about offering the most advanced and personalized treatments for each patient. The application of this classification in rhinoplasty allows us to guarantee safer procedures with better aesthetic results. If you are considering a rhinoplasty, do not hesitate to consult us for a detailed evaluation of your case.