THE USE OF THE LABIOCOLUMELLAR CREASE INCISION IN RHINOPLASTY

Aurel Rethi, in 1934, first described the transverse upper columellar incision for open rhinoplasty for resection of a portion of columella in cases of overly projecting nasal tip. The mid columellar incision h as come to be known as the ''Rethi'' incision. Numerous variations of this approach have been popularized through the years. Recently, a gre at debate has raged over the criteria to be used in selecting patients for rhinoplasty. In this paper, we review 100 consecutive rhinoplasti es and discuss our technique of labiocolumellar crease incision for op en approach, and relate the criteria that we utilize to select patient s for open rhinoplasty. There were 37 male and 63 female patients. Of these, 32 primary, 45 secondary, 18 cleft, and 5 reconstructive rhinop lasties were performed. Twenty-eight percent of primary, 62% of second ary, 78% of cleft, and 80% of reconstructive rhinoplasties were perfor med using the open approach via the labiocolumellar crease incision. T here were no cases of circulatory compromise of the columella. The pre sence of a scar along the columella base (as with the C-flap in cleft patients) should be an indication for open rhinoplasty. Several myths about the labiocolumellar crease incision are dispelled. Adhering to p rinciples of aesthetic subunits should guide the surgeon to place scar s in a less noticeable position.