Video 4.11: The Pitanguy Ligament Preserved in the Closed Technique

What this video shows

Video 4.11 shows the Pitanguy ligament in the closed technique, where it is not transected by a columellar incision and can therefore be preserved with its vessels and lymphatics. The book stresses that the columella, one of the main aesthetic units of the nose, carries the columellar artery, vein, lymphatics and the Pitanguy ligament, and that avoiding the open approach preserves all of them.

Preserving this structure is one of the reasons the closed atraumatic technique heals quickly, and it also provides a reliable anchor for the deep SMAS suture shown in Video 4.12.

Key points

• Pitanguy ligament visualised through a closed approach.

• Structure kept intact together with columellar vessels and lymphatics.

• Serves as anchor for the deep SMAS suture.

In the book: Chapter 4 – Nasal Tip Surgery, section 4.3.8 The Mystery of the Pitanguy Ligament, pp. 96–98 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.