The Use of Fibrin Glue in the Correction of Pollybeak Deformity: A Preliminary Report

Background  Supratip fullness, also known as pollybeak deformity, is one of the most common postoperative complications of rhinoplasty. The deformity can result from many different causes, some of which are related to the surgical technique and can be prevented. Poor redraping of thick, inelastic skin and thick subcutaneous tissues over the reduced cartilaginous framework may result in the creation of a subcutaneous "dead space," leading to the formation of excessive subcutaneous scar and a soft tissue pollybeak in some cases. Objective  To evaluate the effectiveness of a homologous fibrin glue (Tisseel; Baxter AG, Vienna, Austria) in the prevention and correction of the soft tissue pollybeak deformity. Design  Prospective study. Patients and Methods  Thirty patients were treated with fibrin glue to achieve better adherence of the skin to the underlying skeletal framework. Ten patients had no previous nasal surgery. The remaining 20 patients presented with the complication of pollybeak deformity. In this group, 14 patients had undergone 1 previous surgical procedure, 3 had undergone 3 previous rhinoplasties, and 3 had undergone 4 or more previous procedures. Results  There were no intraoperative or postoperative complications. Follow-up ranged from 2 to 34 months, with all patients achieving successful aesthetic outcomes. Conclusion  Fibrin glue is an excellent adjunct to rhinoplasty procedures because it successfully eliminates the dead space that can cause soft tissue pollybeak deformity.