A Prospective Comparison of Inverted V Mid-Columellar and V-Shaped Columellar-Labial Incisions in Reconstructive Rhinoplasty Publisher



Sazgar AA ; Aalizade A ; Zeyfoalzam M ; Golparvaran S ; Sazgar MA
Source: Aesthetic Plastic Surgery Published:2026

Abstract

Background: Reconstructive rhinoplasty for severely deformed noses requires meticulous technique. While reusing mid-columellar incisions is a common practice, a V-shaped columella-labial incision with V-Y closure may provide superior results. We conducted a prospective study to compare the outcomes of these two approaches. Methods: This study included 52 patients (n = 26 per group) who underwent reconstructive rhinoplasty. Group A received a V-shaped columella-labial incision, while Group B received a mid-columellar incision. All surgeries were performed by the same surgeon. Standardized pre- and one-year postoperative photographs were analyzed for changes in nasal projection, columellar height, and scar quality (Stony Brook Scar Evaluation Scale) by independent evaluators. Results: The V-shaped incision group demonstrated significantly greater improvement in nasal projection after adjustment for baseline differences (adjusted p = 0.002) and greater columellar height gain (p < 0.001) compared with the mid-columellar group. Linear regression analysis confirmed that columellar incision type remained an independent predictor of projection change after controlling for preoperative projection. Scar assessments showed no significant difference between groups (p = 0.557). Conclusion: The V-shaped columella-labial incision provides significantly greater improvement in nasal projection and columellar height without increasing scar-related concerns. This technique demonstrates reliability as an initial approach for managing severely compromised nasal structures, though further studies are warranted. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2026.