Video 4.10: The Pitanguy Ligament Seen in the Open Technique

What this video shows

Video 4.10 shows the Pitanguy ligament, the midline SMAS structure of the nose, as it appears in the open technique. The book describes its two branches: a superficial branch that extends down close to the columellar skin between the medial crura, and a deep branch that extends down just before the anterior caudal angle of the septum and unites with the depressor septi nasi muscle.

This tissue is an envelope rich in blood vessels and lymphatics; it can be used as a flap in reconstructive procedures and, because its start and end points are known, as an anchor for redraping. Video 4.11 shows the same structure in the closed technique.

Key points

• Superficial and deep branches of the Pitanguy ligament identified.

• Rich in vessels and lymphatics; usable as a flap or as a redraping anchor.

• Compare with the closed-technique view in Video 4.11.

In the book: Chapter 4 – Nasal Tip Surgery, section 4.3.8 The Mystery of the Pitanguy Ligament, pp. 96–97 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.