{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:55:50Z","timestamp":1792515350215,"version":"4.5.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"13","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003010","name":"Ege University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003010","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aesth Plast Surg"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Retrocolumellar perforations (RCPs) are rare complications of revision rhinoplasty, often associated with columellar retraction, shortened nasal length, and loss of tip projection. Their repair requires vascularized flaps that provide both mucosal coverage and structural support at the tip.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the surgical outcomes of RCP repair using endonasal and gingivobuccal flaps, with emphasis on perforation closure, nasal tip projection, and patient-reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of 28 patients (mean age 35.6 years; 17 men, 11 women) underwent RCP repair. Most had \u2265\u00a02 prior nasal surgeries (71.4%). Risk factors included smoking (64.3%) and cocaine use (35.7%). All patients had nasal skin contraction, short noses, and a retracted columella. Flap techniques were selected according to intraoperative anatomy, and rib cartilage grafts were used in all cases. Outcomes were assessed by perforation status, nasal tip projection, and the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Perforation closure was achieved in 27 of 28 patients (96.4%). Stable and desired nasal tip projection was maintained in 23 patients (82.1%), whereas 4 patients had drooping nasal tips despite RCP closure. SCHNOS scores improved significantly from 18.2 \u00b1 8.5 preoperatively to 89.4 \u00b1 10.7 postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001, Cohen\u2019s d = 3.68). Among patients reconstructed with gingivobuccal flaps (n\u2009=\u200918), 16\/18 (88.9%) maintained stable tip projection, suggesting a favorable trend but not demonstrating superiority.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RCP repair using structured vascularized flaps achieves high closure rates, reliable nasal tip support, and significant functional and cosmetic improvement. Gingivobuccal flaps are particularly valuable in revision cases with compromised anterior support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence IV<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.springer.com\/00266\" ext-link-type=\"uri\">www.springer.com\/00266<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00266-026-05849-5","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:11:09Z","timestamp":1777925469000},"page":"4947-4961","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Revision Rhinoplasty in Retrocolumellar Perforation"],"prefix":"10.1007","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2148-0723","authenticated-orcid":false,"given":"Sercan","family":"G\u00f6de","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9398-4261","authenticated-orcid":false,"given":"Aynur","family":"Aliyeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3201-3917","authenticated-orcid":false,"given":"Mehmet Burak","family":"Apayd\u0131n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6494-8664","authenticated-orcid":false,"given":"Elad","family":"Azizli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"5849_CR1","doi-asserted-by":"publisher","first-page":"1664","DOI":"10.1016\/j.bjps.2018.07.019","volume":"71","author":"C Bergel","year":"2018","unstructured":"Bergel C, Alshukry A, Kerfant N, et al. Reconstruction of columellar defects: which surgical technique to choose? A retrospective study of 18 patients. J Plast Reconstr Aesthet Surg. 2018;71:1664\u201378.","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"5849_CR2","doi-asserted-by":"publisher","first-page":"486","DOI":"10.14639\/0392-100X-1313","volume":"37","author":"M Cassano","year":"2017","unstructured":"Cassano M. Endoscopic repair of nasal septal perforation. Riparazione della perforazione del setto nasale con tecnica endoscopica. Acta Otorhinolaryngol Ital. 2017;37:486\u201392.","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"5849_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-016-0131-9","author":"S Sertel","year":"2016","unstructured":"Sertel S, Venara-Vulpe II, Pasche P. Correction of severe columella and tip retraction in silicone implanted Asian short noses. J Otolaryngol Head Neck Surg. 2016. https:\/\/doi.org\/10.1186\/s40463-016-0131-9.","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"5849_CR4","doi-asserted-by":"publisher","DOI":"10.3390\/cmtr18010017","author":"NA Alexander","year":"2025","unstructured":"Alexander NA, Enin K, Ji J, Spataro E. Functional and aesthetic outcomes of post-Mohs nasal reconstruction. Craniomaxillofac Trauma Reconstr. 2025. https:\/\/doi.org\/10.3390\/cmtr18010017.","journal-title":"Craniomaxillofac Trauma Reconstr"},{"issue":"1","key":"5849_CR5","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1055\/a-2034-8397","volume":"40","author":"R Mandavia","year":"2024","unstructured":"Mandavia R, Parmar D, Ahmed MN, et al. An overview of rhinoplasty practices: European Academy of Facial Plastic Surgery, collaborative cross-sectional study. Facial Plast Surg. 2024;40(1):31\u20135. https:\/\/doi.org\/10.1055\/a-2034-8397.","journal-title":"Facial Plast Surg"},{"key":"5849_CR6","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1001\/jamafacial.2014.914","volume":"17","author":"JH Wee","year":"2015","unstructured":"Wee JH, Park MH, Oh S, Jin HR. Complications associated with autologous rib cartilage use in rhinoplasty: a meta-analysis. JAMA Facial Plast Surg. 2015;17:49\u201355.","journal-title":"JAMA Facial Plast Surg"},{"key":"5849_CR7","first-page":"102","volume":"26","author":"M Re","year":"2006","unstructured":"Re M, Paolucci L, Romeo R, Mallardi V. Surgical treatment of nasal septal perforations. Our experience. Acta Otorhinolaryngol Ital. 2006;26:102\u20139.","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"5849_CR8","doi-asserted-by":"publisher","first-page":"e104","DOI":"10.1097\/SCS.0000000000008774","volume":"34","author":"Q Zeng","year":"2023","unstructured":"Zeng Q, Hu YG, Tang YX, Yu BF, Li XL. Complications and treatments of Pseudomonas aeruginosainfection after rhinoplasty with implants: a clinical study. J Craniofac Surg. 2023;34:e104\u20138.","journal-title":"J Craniofac Surg"},{"key":"5849_CR9","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-01377-5","author":"Q Zeng","year":"2025","unstructured":"Zeng Q, Tang YX, Yu BF. Prosthetic bacterial culture for bacterial identification of nasal infections after rhinoplasty. Sci Rep. 2025. https:\/\/doi.org\/10.1038\/s41598-025-01377-5.","journal-title":"Sci Rep"},{"key":"5849_CR10","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1089\/fpsam.2020.0465","volume":"23","author":"DM Toriumi","year":"2021","unstructured":"Toriumi DM, Kowalczyk DM, Cristel RT, et al. Evaluation of postoperative infection rates in 3084 rhinoplasty cases using antibiotic soaks and\/or irrigations. Facial Plast Surg Aesthet Med. 2021;23:368\u201374.","journal-title":"Facial Plast Surg Aesthet Med"},{"key":"5849_CR11","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1016\/j.bjorl.2020.07.001","volume":"88","author":"JY Hudise","year":"2022","unstructured":"Hudise JY, Aldhabaan SA, Aldosari BF. Complications of the nasal dorsum reconstruction using autologous or alloplastic grafts: evidence from systematic review and meta-analysis. Braz J Otorhinolaryngol. 2022;88:406\u201320.","journal-title":"Braz J Otorhinolaryngol"},{"key":"5849_CR12","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.00000000000008574","author":"A Bayoumi","year":"2023","unstructured":"Bayoumi A, Elamin A, El-Sawy A, Hussein AYZ, Ezzat A. Endoscopic unilateral anterior ethmoid artery flap with or without cartilage graft for nasal septal perforation repair. Ann Med Surg (Lond). 2023. https:\/\/doi.org\/10.1097\/MS9.00000000000008574.","journal-title":"Ann Med Surg (Lond)"},{"key":"5849_CR13","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1002\/lary.29748","volume":"132","author":"A Santamar\u00eda-Gadea","year":"2022","unstructured":"Santamar\u00eda-Gadea A, Langdon C, Alobid I. Extended anterior ethmoidal artery flap: novel endoscopic technique for large septal perforation. Laryngoscope. 2022;132:298\u2013300.","journal-title":"Laryngoscope"},{"key":"5849_CR14","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1002\/lary.24319","volume":"124","author":"MR Patel","year":"2014","unstructured":"Patel MR, Taylor RJ, Hackman TG, et al. Beyond the nasoseptal flap: outcomes and pearls with secondary flaps in endoscopic endonasal skull base reconstruction. Laryngoscope. 2014;124:846\u201352.","journal-title":"Laryngoscope"},{"key":"5849_CR15","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1177\/1945892418816959","volume":"33","author":"MN Cavada","year":"2018","unstructured":"Cavada MN, Orgain CA, Alvarado R, Sacks R, Harvey RJ. Septal perforation repair utilizing an anterior ethmoidal artery flap and collagen matrix. Am J Rhinol Allergy. 2018;33:256\u201362.","journal-title":"Am J Rhinol Allergy"},{"key":"5849_CR16","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1001\/jamafacial.2017.1083","volume":"20","author":"SP Moubayed","year":"2018","unstructured":"Moubayed SP, Ioannidis JPA, Saltychev M, Most SP. The 10-item standardized cosmesis and health nasal outcomes survey (SCHNOS) for functional and cosmetic rhinoplasty. JAMA Facial Plast Surg. 2018;20:37\u201342.","journal-title":"JAMA Facial Plast Surg"},{"issue":"6","key":"5849_CR17","doi-asserted-by":"publisher","first-page":"2115","DOI":"10.1007\/s00405-020-06230-1","volume":"278","author":"A Santamar\u00eda-Gadea","year":"2021","unstructured":"Santamar\u00eda-Gadea A, Vaca M, de Los SG, Alobid I, Mari\u00f1o-S\u00e1nchez F. Greater palatine artery pedicled flap for nasal septal perforation repair: radiological study and case series. Eur Arch Oto-Rhino-Laryngol. 2021;278(6):2115\u201321.","journal-title":"Eur Arch Oto-Rhino-Laryngol."},{"key":"5849_CR18","doi-asserted-by":"publisher","first-page":"1824","DOI":"10.1002\/lary.30458","volume":"133","author":"B Arana-Fern\u00e1ndez","year":"2023","unstructured":"Arana-Fern\u00e1ndez B, Santamar\u00eda-Gadea A, Almeida-Parra F, Mari\u00f1o-S\u00e1nchez F. Oroantral fistula closure using double-layered flap: greater palatine artery flap and buccal fat pad. Laryngoscope. 2023;133:1824\u20137.","journal-title":"Laryngoscope"},{"key":"5849_CR19","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1308\/003588408X301136","volume":"90","author":"S Misra","year":"2008","unstructured":"Misra S, Chaturvedi A, Misra NC. Management of gingivobuccal complex cancer. Ann R Coll Surg Engl. 2008;90:546\u201353.","journal-title":"Ann R Coll Surg Engl"},{"key":"5849_CR20","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1001\/jamafacial.2016.1829","volume":"19","author":"J Feldman","year":"2017","unstructured":"Feldman J, Marcus B. Revisiting the labial-buccal sulcus flap for septal perforation closure: review at a single institution. JAMA Facial Plast Surg. 2017;19:241\u20133.","journal-title":"JAMA Facial Plast Surg"},{"key":"5849_CR21","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.72197","author":"HJ Karekar","year":"2024","unstructured":"Karekar HJ, Dafe T, Gandole SS. Post-surgery physical rehabilitation for gingivobuccal sulcus: a case report. Cureus. 2024. https:\/\/doi.org\/10.7759\/cureus.72197.","journal-title":"Cureus"},{"key":"5849_CR22","doi-asserted-by":"publisher","first-page":"1658","DOI":"10.1097\/SCS.0b013e31826460fd","volume":"23","author":"SJ Yang","year":"2012","unstructured":"Yang SJ, Choi JW, Chung YS, et al. Midfacial degloving approach for resectioning and reconstruction of extensive maxillary fibrous dysplasia. J Craniofac Surg. 2012;23:1658\u201361.","journal-title":"J Craniofac Surg"},{"key":"5849_CR23","first-page":"361","volume":"57","author":"M M\u00fcller","year":"2003","unstructured":"M\u00fcller M, Betlejewski S. Stan b\u0142ony \u015bluzowej nosa u chorych na cukrzyce [Nasal mucosa in patients with diabetes mellitus]. Otolaryngol Pol. 2003;57:361\u20134.","journal-title":"Otolaryngol Pol"},{"key":"5849_CR24","first-page":"845","volume":"60","author":"G Blaise","year":"2005","unstructured":"Blaise G, Vanhooteghem O, De La Brassinne M. Perforation de la cloison nasale dans un contexte d\u2019inhalation de coca\u00efne [Perforation of the nasal septum in cocaine abusers]. Rev Med Liege. 2005;60:845\u20138.","journal-title":"Rev Med Liege"},{"key":"5849_CR25","doi-asserted-by":"publisher","first-page":"1617","DOI":"10.1177\/00034894231176610","volume":"132","author":"P Tumlin","year":"2023","unstructured":"Tumlin P, Assi S, Armeni M, Ramadan HH, Reyes C, Makary CA. Outcome of endoscopic repair of nasal septal perforation. Ann Otol Rhinol Laryngol. 2023;132:1617\u201320.","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"5849_CR26","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1093\/asj\/sjw204","volume":"37","author":"A Topkara","year":"2017","unstructured":"Topkara A. Three-dimensional (3D) columellar strut graft in rhinoplasty. Aesthetic Surg J. 2017;37:398\u2013406.","journal-title":"Aesthetic Surg J"},{"key":"5849_CR27","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1055\/s-0030-1255337","volume":"24","author":"R Squaquara","year":"2010","unstructured":"Squaquara R, Kim Evans KF, Spanio di Spilimbergo S, Mardini S. Intraoral reconstruction using local and regional flaps. Semin Plast Surg. 2010;24:198\u2013211.","journal-title":"Semin Plast Surg"}],"container-title":["Aesthetic Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-026-05849-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00266-026-05849-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-026-05849-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T19:11:22Z","timestamp":1785784282000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00266-026-05849-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":27,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["5849"],"URL":"https:\/\/doi.org\/10.1007\/s00266-026-05849-5","relation":{},"ISSN":["0364-216X","1432-5241"],"issn-type":[{"value":"0364-216X","type":"print"},{"value":"1432-5241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"29 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"None of the authors has declared any conflict of interest (financial or non-financial) from being named as an author on the manuscript. Agreement exists between the authors, and the disclosure form has been signed by the corresponding author on behalf of all authors.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was received for this study from the Ege University Medical Research Ethics Committee. (Approval IRB No: 25-5.1T\/32, Approval date: May 22, 2025)","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants included in the study. In addition, separate consent was obtained from patients whose photographs were used for the use and sharing of their images.","order":3,"name":"Ethics","label":"Informed Consent","group":{"name":"EthicsHeading","label":"Declarations"}}]}}