Yeungnam Univ J Med.  2020 Jan;37(1):32-39. 10.12701/yujm.2019.00290.

Nasal tip plasty using three-dimensional printed polycaprolactone (Smart Ball^®)

• Kim JH
• Kim GW
• Kang WK

• KMID: 2501405
• DOI: http://doi.org/10.12701/yujm.2019.00290

Abstract

Background
Rhinoplasty is one of the most commonly performed cosmetic surgery procedures. Most Asians desire elevation of their relatively flat nasal dorsum and tip to make them appear more prominent. This study introduces a simple method of nasal tip plasty using three-dimensional (3D)-printed polycaprolactone (PCL) (Smart Ball^®), which provides the required length and volume for this purpose and enables the creation of a nasal tip of the desired shape in a safe and simple manner.
Methods
Between September 2014 and May 2017, 22 patients participated in a survey to assess postoperative satisfaction levels. Additionally, three plastic surgeons compared patients’ pre- and 1-year postoperative photographs to evaluate the results. All patients underwent 2- to 4-year postoperative follow-up.
Results
Levels of subjective satisfaction among patients were 3.59, 3.50, 3.82, 3.73, 3.55, and 3.82 for each of the 6 categories evaluated, with a mean of 3.67/4 points, indicating high satisfaction levels. The mean plastic surgeon-reported score for the 22 patients was 4.47/5 points, which also indicates highly successful outcomes. Postoperative nasal tip rotation and tip projection were ideal in most patients.
Conclusion
Our novel method using 3D-printed PCL (Smart Ball®) provides the optimal length and volume required for nasal tip plasty and enables the creation of a nasal tip of the desired shape, in a safe and simple manner. An advantage of our method is that it retains the original nasal structure in contrast to structural changes observed with the use of conventional methods.

Keyword

Bioprinting; Plastic surgery; Polycaprolactone; Rhinoplasty

Figure

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  Fig. 1. Photographs show a typical Asian nose with a flat nasal dorsum and tip (Asians typically have thicker skin and a lower nose). (A) Three-quarter view. (B) Lateral view.

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  Fig. 2. The Rhinoplasty Outcomes Evaluation survey administered to patients.

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  Fig. 3. Measurement of the degree of nasal tip rotation and tip projection. (A) Nasolabial angle. (B) Columellar-lobular angle. (C) Tip projection.

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  Fig. 4. Preoperative markings in the area of implant insertion. Three-quarter view.

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  Fig. 5. Photograph shows an infracartilaginous incision.

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  Fig. 6. (A) Measurement of the size of Smart Ball® after trimming it to the appropriate size. (B) Fixation of the Smart Ball® implant using a suture and cutting the remaining suture before insertion.

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  Fig. 7. Photographs obtained immediately after insertion of the Smart Ball® implant. Three-quarter view.

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  Fig. 8. Representative case of a patient (case 1) show an excellent surgical outcome. Preoperative (A, C, E) and 14-month postoperative (B, D, F) photographs of a 27-year-old woman who underwent nasal tip plasty using Smart Ball® for nasal tip ptosis.

Reference

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