{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:15:46Z","timestamp":1790367346461,"version":"4.1.0"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Achieving long-term stability of nasal tip rotation and projection remains a challenge in rhinoplasty because of postoperative remodeling processes such as edema resolution, soft tissue redraping, and scar maturation. This study evaluated the temporal changes in nasal tip rotation and projection following rhinoplasty using the Pentagonal Tip Support Technique (PTST). Materials and Methods: A retrospective analysis was conducted on patients undergoing primary rhinoplasty using PTST, with standardized photographic assessments performed intraoperatively and at 6 and 12 months postoperatively. Nasal tip rotation and projection were quantified using the nasolabial angle and Goode ratio, respectively, and temporal changes were analyzed across postoperative intervals. Results: Both parameters demonstrated statistically significant reductions over time. However, the majority of changes occurred within the first 6 months, whereas later follow-up intervals demonstrated smaller changes and a reduced rate of change. Similar temporal patterns were observed across different skin types, and skin type was not significantly associated with late postoperative changes in rotation or projection. Conclusions: The findings of the present study suggest that PTST is associated with a temporal pattern characterized by greater early postoperative changes followed by smaller interval changes during later follow-up. These findings may reflect postoperative healing dynamics and structural support behavior following rhinoplasty. However, further prospective comparative studies are needed to better define the clinical behavior of PTST over extended follow-up periods relative to established structural rhinoplasty techniques.<\/jats:p>","DOI":"10.3390\/medicina62061060","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T08:09:16Z","timestamp":1780301356000},"page":"1060","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Temporal Stability of Nasal Tip Rotation and Projection Following Rhinoplasty Using a Novel Integrated Pentagonal Tip Support Technique"],"prefix":"10.3390","volume":"62","author":[{"given":"\u015eamil","family":"\u015eahin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Private ENT Practice, 34380 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burak","family":"Erkmen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Private ENT Practice, 34380 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9147-0250","authenticated-orcid":false,"given":"Mehmet Nuri","family":"Elg\u00f6rm\u00fc\u015f","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Atlas University, 34408 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye\u015fim Esen Yi\u011fit","family":"Ko\u00e7er","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Umraniye Research and Training Hospital, 34764 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4887-4677","authenticated-orcid":false,"given":"Ya\u015far Kemal","family":"Duymaz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Sultan Abdulhamid Han Research and Training Hospital, 34668 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim Engin","family":"\u00c7ekin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Sultan Abdulhamid Han Research and Training Hospital, 34668 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Seidel, D.U., Rotter, N.K., Scheithauer, M.O., Ebeling, O., and Bode, S. (2025). Advances in Rhinoplasty Evidence: A Narrative Overview of Recent Meta-analyses (2015\u20132025). Facial Plastic Surgery, Thieme Medical Publishers, Inc.","DOI":"10.1055\/a-2778-9712"},{"key":"ref_2","unstructured":"Mansour, H.R.K., Malik, A., North, A.S., and Joshi, A. (2026). Nasal Aesthetic Preferences Across Populations: A Systematic Review of Cultural, Ethnic, and Generational Trends. Aesthet. Surg. J., sjag062."},{"key":"ref_3","first-page":"351","article-title":"Management of Nasal Tip Deformities in Revision Rhinoplasty","volume":"42","author":"Ramirez","year":"2025","journal-title":"Facial Plast. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1097\/SAP.0000000000004489","article-title":"Optimizing Nasal Tip Position: A Systematic Review of Columellar Strut and Septal Extension Grafts","volume":"95","author":"Amador","year":"2025","journal-title":"Ann. Plast. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2953","DOI":"10.1007\/s00266-025-05344-3","article-title":"Evaluating the Role of Columellar Strut Grafts in the ERA of Septal Extension in Preservation Rhinoplasty","volume":"50","author":"Ishida","year":"2025","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/PRS.0000000000011132","article-title":"Nasal Tip Flexibility and Stability: Comparison of Septal Extension Grafts and Columellar Strut Grafts in a Prospective Trial","volume":"154","author":"Kucukguven","year":"2024","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1007\/s00266-022-02858-y","article-title":"Effect of Tongue-in-Groove Technique on Upper Lip Slope in Rhinoplasty","volume":"46","author":"Sazgar","year":"2022","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_8","first-page":"312","article-title":"Structural Nasal Tip Grafting: Anatomy, Evaluation, and Technique Selection for Durable Aesthetic and Functional Outcomes","volume":"42","author":"Lee","year":"2025","journal-title":"Facial Plast. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"254e","DOI":"10.1097\/PRS.0000000000011094","article-title":"Use of the Interalar Ligament Flap for Tip and Supratip Contouring in Primary Open Structural Rhinoplasty","volume":"154","author":"Marianetti","year":"2024","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1055\/a-2764-3510","article-title":"Skin and Soft Tissue Management in Primary Rhinoplasty","volume":"42","author":"Eskander","year":"2026","journal-title":"Facial Plast. Surg."},{"key":"ref_11","first-page":"4384","article-title":"The Difference between the Effect of Septal and Conchal Columellar Strut on Nasal Aesthetics","volume":"30","author":"Mansour","year":"2024","journal-title":"Zagazig Univ. Med. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s00266-023-03467-z","article-title":"Long-Term Control of Nasal Tip Position: Quantitative Assessment of Caudal Septal Extension Graft","volume":"48","author":"Mookerjee","year":"2024","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Nocini, R., Magagnotto, N., Chirumbolo, S., Albanese, M., and Bertossi, D. (2025). New Insights into the Role of Columellar Strut and Septal Extension Graft: A Comparative Review of Long-Term Outcomes. Diagnostics, 15.","DOI":"10.3390\/diagnostics15162051"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"218","DOI":"10.31486\/toj.22.0006","article-title":"Preserving Nasal Tip Rotation and Projection in Open Septorhinoplasty","volume":"22","author":"Pou","year":"2022","journal-title":"Ochsner J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3660","DOI":"10.1007\/s00266-026-05615-7","article-title":"Long-Term Durability of Tip Projection and Rotation with Strut Columella and Septal Extension Graft in Rhinoplasty: A 6-Month and 1-Year Follow-Up","volume":"50","author":"Vaghardoost","year":"2026","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s00238-025-02321-6","article-title":"Comparing long-term nasal projection and rotation outcomes in rhinoplasty: A systematic review and meta-analysis of columellar strut graft versus septal extension graft","volume":"48","author":"Mahmoud","year":"2025","journal-title":"Eur. J. Plast. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/PRS.0000000000010147","article-title":"Superiority of the Septal Extension Graft over the Columellar Strut Graft in Primary Rhinoplasty: Improved Long-Term Tip Stability","volume":"152","author":"Bellamy","year":"2023","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"603e","DOI":"10.1097\/PRS.0000000000010257","article-title":"Current Surgical Outcomes of Nasal Tip Grafts in Rhinoplasty: A Systematic Review","volume":"152","author":"Skochdopole","year":"2023","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1097\/PRS.0000000000011697","article-title":"Nasal Tip Deprojection in Rhinoplasty","volume":"155","author":"Datta","year":"2024","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1007\/s00266-013-0141-1","article-title":"Comparison of the effects of columellar strut and septal extension grafts for tip support in rhinoplasty","volume":"37","author":"Akkus","year":"2013","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"772e","DOI":"10.1097\/PRS.0000000000006178","article-title":"Control of Nasal Tip Position: Quantitative Assessment of Columellar Strut versus Caudal Septal Extension Graft","volume":"144","author":"Perkins","year":"2019","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1007\/s00266-019-01330-8","article-title":"Caudal Septal Extension Graft Sutured with Absorbable Material and Not Fixed to the Nasal Spine Region Compared with the Conventional Fixation Method: A Retrospective Study","volume":"43","author":"Benavides","year":"2019","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_23","first-page":"396","article-title":"Comparative Outcomes of Septal Extension versus Columellar Strut Grafts for Nasal Tip Stabilization and Positioning in Rhinoplasty: A Systematic Review and Meta-analysis","volume":"42","author":"Ozgenc","year":"2025","journal-title":"Facial Plast. Surg."},{"key":"ref_24","first-page":"935","article-title":"The Effect of the Membranous Tongue-in-Groove Technique on Projection and Rotation in Patients Undergoing Closed Rhinoplasty","volume":"50","year":"2025","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1007\/s00266-023-03460-6","article-title":"Rhinoplasty for Thick-Skinned Noses: A Systematic Review","volume":"47","author":"Vahidi","year":"2023","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.fsc.2024.06.004","article-title":"Management of Thick Skin in Rhinoplasty","volume":"32","author":"Cobo","year":"2024","journal-title":"Facial Plast. Surg. Clin. N. Am."},{"key":"ref_27","first-page":"343","article-title":"Tip Tensioning in Rhinoplasty","volume":"42","author":"Schertzer","year":"2025","journal-title":"Facial Plast. Surg."},{"key":"ref_28","first-page":"326","article-title":"Combining Preservation Concepts and Structural Techniques in Nasal Tip Management: A Practical Approach","volume":"42","author":"Buttarelli","year":"2025","journal-title":"Facial Plast. Surg."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1060\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T08:48:01Z","timestamp":1780303681000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/6\/1060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,30]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["medicina62061060"],"URL":"https:\/\/doi.org\/10.3390\/medicina62061060","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,30]]}}}