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J Korean Soc Aesthetic Plast Surg. 2009 Mar;15(1):49-54. Korean. Original Article.
Jeong JY , Oh SH , Lee SR , Kang NH , Kim DW .
PLUS Aesthetic Clinic, Daejeon
Department of Plastic & Reconstructive Surgery, College of Medicine, Chungnam National University, Daejeon, Korea. djplastic@cnu.ac.kr
Department of Anatomy, College of Medicine, Chungnam National University, Daejeon, Korea.
Abstract

Hyper-activated depressor septi nasi is an important factor caused a nasal tip drooping and many studies have been carried out, however it still remains controversial. This study presents a surgical modality for its intervention, based on the anatomical study. Eleven fixed and six fresh cadavers were used for the study. We found that the depressor septi nasi was consisted of three fascicles. Medial fascicles were inserted into the dermocartilaginous ligament, and deep fibers of the medial fascicles were attached to the anterior nasal spine. After superficial fibers were interdigitated with the orbicularis oris, they were attached to the alveolar bone. Intermedial fascicles were inserted to the footplates of the medial cruses and the caudal septum. After they were interdigitated with the medial fascicle and the orbicularis oris, they were attached to the alveolar bone. From April to August 2008, five patients had surgical intervention for hyper-activated depressor septi nasi. Medial and intermedial fascicles were detached completely from the anterior nasal spine and the septum through intranasal approach. Tip droopings were improved in all cases. Specific complications were not found. We believe that surgical intervention through intranasal approach is a useful method for correction of tip drooping.

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