摘要

Objectives: Majority of primary and secondary rhinoplasties are presently done by open approach. Bad scar on the columella might spoil the general impression after an otherwise excellent rhinoplasty. Objective with this presentation is to familiarize the audience with the better way to place incision, which will leave the columella intact and will give the superior exposure of the anatomic structures of the nose tip. Introduction: Several types of incision and division of columella are popular, all placed in the central segment of the columella. The aim of this article was to convey experience with columellar incision in the labio-columellar junction, which in author’s opinion results in better cosmesis and in an intact columella. Materials / method: The review of 483 rhinoplasties performed during the four years 2018-2021 was undertaken. Labiocolumellar incision through the border of the two distinct aesthetic units the columella and the upper lip was chosen for all 140 patients operated by the open approach. Scars were evaluated with respect to visibility, color match and alinement to the surface of the surrounding skin, and were graded into three categories: excellent, good and poor. Skin and carnation type, depending on amount of melanin pigment in the skin, according to Fitzpatrick was determined for all patients. The correla Results: Results Columellar scars could be evaluated in 94 patients who were seen ≥ 1 year after operation. The scar was excellent or practically invisible in 55 patients (59 %) and good or barely perceptible in 28 (30%). Poor or visible scars were seen in 11 patients (11%). Most of them were previously operated one or several times. Excellent and good scars were significantly more common than visible and bad scars (p < .001). The quality of the scar in the labio-columellar junction did not depend on, if patients had the lighter or darker skin. Both surgeon and the patients were satisfied. Conclusion: Advantage of the incision in the labio-columellar junction was full exposure of the columellar anatomic structures, and better control and planning of the desired shape of columella. Junction incision results in less conspicuous scar, than incisions on the central segment of columella.LCI incision is the only rationale alternative if open rhinoplasty and an uppel lip lift by the bull horn incision are planned in the same session