Video 2.7: Ligament-Based Redraping Using the Pitanguy, Scroll and Pyramidal Ligaments

What this video shows

According to the Room Concept, the ligaments of the nose are the anchor points for redraping. Video 2.7 shows how the excessive skin of the lower third of the nose is adapted to the nasal skeleton using the Pitanguy and scroll ligaments, while the excess skin of the upper two-thirds is adapted with the pyramidal ligament.

The book emphasises that redraping can continue as long as the ligaments are preserved or repaired, which is why ligament preservation runs through every stage of the closed atraumatic technique. Proper closure of the skin and mucosal incisions follows this step to prevent early complications such as wounds, infection, bleeding and oedema, and late problems such as retraction and hypertrophic scars.

Key points

• Lower third: Pitanguy and scroll ligaments are used as redraping anchors.

• Upper two-thirds: the pyramidal ligament is used.

• Preserved or repaired ligaments make continued redraping possible.

In the book: Chapter 2 – Closed Atraumatic Rhinoplasty, section 2.2.8 Redraping and Closure, p. 16 of Rhinoplasty in Practice: An Algorithmic Approach to Modern Surgical Techniques (CRC Press, 2021). About the book and all companion videos.

Surgeon: Prof. Dr. Suleyman Tas, plastic, reconstructive and aesthetic surgeon, Istanbul. This video is part of the surgeon-training material of the book; patients considering rhinoplasty in Istanbul can use it to understand the techniques used at Prof. Dr. Suleyman Tas Clinic.