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Hrachya Arshakyan

In Armenia among aesthetic operations a big part takes rhinoplasty. In some cases patients are complaining on length of the nose, protruding (saggy) columella and decreased naso-labial angle. We have selected a group of such patients and during 2011 year the quantity of included patient reached 50. The group was subdevided into two equal groups. In all cases performed rhinoplasty with open approach. During operations of the first group used septo-columellar submucosal sutures. The sutures were putting between inferior free margin of the septal cartilage and medial cruses of the major alar cartilages - the skeleton of the columella. We used 2 nonabsorbable sutures (prolene 5/0) at proximal and medial thirds of the inferior septal margin. And the second group operated without such sutures.

Main goal of this manipulation directed to provide more ability for elevation of the columella and its stabilisation in the central position, than gives classical methods (resecting lower part of the septal cartilage and mucosa resection).

So septo-columellar submucosal sutures give the following privileges:
1. fine control under position (level) of the columella
2. centralization and stabilization of the columella
3. during a time the columella keeps his position
4. the sutures can be easily removed throw small incision under local anesthesia, which gives about 50% (if they are removing in early postoperative period) down-movement of the columella edge

In 2 cases it had been needed to remove sutures. In first group all 25 patients were satisfied with results.

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