Association of Increasing Nasal Tip Projection With Lip Position in Primary Rhinoplasty
Why this work is in the frame
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Bibliographic record
Abstract
IMPORTANCE: The effects of rhinoplasty maneuvers on adjacent facial features are an important component in preoperative planning and patient counseling. Tip projection modifications are commonly performed in both cosmetic and reconstructive rhinoplasty. OBJECTIVE: To evaluate the subsequent change in lip projection that results from increasing nasal tip projection. DESIGN, SETTING, AND PARTICIPANTS: In this case series, 20 patients underwent primary rhinoplasty with the objective of increasing tip projection during the period from October 1, 2014, to September 25, 2015. Preoperative and postoperative photographs were evaluated. MAIN OUTCOMES AND MEASURES: The increased tip projection was verified using the Goode ratio. Upper lip projection was calculated by the Z angle, which is based on the intersection between the Frankfort horizontal plane and the profile line. Vermilion height was also assessed. RESULTS: Of the 20 patients in the study (19 females and 1 male; mean [SD] age, 26.8 [10.2] years; range, 16-52 years) 18 (90%) demonstrated an increase in upper lip projection when the tip projection was increased by either a columellar strut or tongue-in-groove maneuver. The Z angle demonstrated a statistically significant decrease of 2.7° (95% CI, 1.5°-3.9°; P < .001). Although the vermilion height did not change a significant amount, there was a trend toward an increase in mean height of 0.051 (95% CI, -0.00515 to -0.10685; P = .09). CONCLUSIONS AND RELEVANCE: Increasing nasal tip projection causes a measurable increase in upper lip projection. This new causal association has been applied to our filler injection armamentarium as an alternative way to achieve the desired result of a more youthful upper lip. LEVEL OF EVIDENCE: 4.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it