Analysis of primary rhinoplasty in elderly patients

Abstract

Background: The upper limit of rhinoplasty age increases as the concept of old age shifts forward. Rhinoplasty operations of this era have their own characteristics. The aim of this study is to point out these characteristic features and propose solutions to the problems observed in our series. Materials and Methods: Between 2014 and 2018, 32 primary rhinoplasties were performed on patients over 55 years of age. A comprehensive preoperative evaluation was done in all cases. Wider skin undermining was a prerequisite to overcome skin redundancy. Proper elevation of the droopy nose was the primary goal. Placement of a wide and homogeneously crushed cartilage graft over the lower and upper lateral cartilages was applied in all patients for structural support in addition to standard measures. In patients with extreme droopiness, a deep temporal or rectus fascial sling was applied between the columella and the nasal dorsum to support tip elevation. Results: The follow-up period was 6 months–4 years. All of the patients were satisfied with the postoperative results except for one case having dorsal irregularities and one case with postoperative relapse of the droopiness. Revisional operations of these patients were performed with the utilization of deep temporal fascia. A pulmonary embolus was encountered in one patient in 56 years of age at the 39th-postoperative day. She was hospitalized, and an anticoagulant treatment was applied. Conclusion: The most important problem in this age group is the droopiness of the tip. The use of a wide and homogeneously crushed septal cartilage graft over both the upper and lower lateral cartilages and autologous fascial sling rising and stabilizing the tip may help to prevent its relapse.

Keywords

• advanced
• age
• cartilage
• crushed
• fascial
• rhinoplasty
• sling