CC BY-NC 4.0 · Arch Plast Surg 2014; 41(01): 3-11
DOI: 10.5999/aps.2014.41.1.3
Topic: Septal Extension Graft

Effective Septal Extension Graft for Asian Rhinoplasty

Jae Hoon Kim
April 31 Plastic Surgery Clinic, Seoul, Korea
,
Jin Woo Song
April 31 Plastic Surgery Clinic, Seoul, Korea
,
Sung Wan Park
April 31 Plastic Surgery Clinic, Seoul, Korea
,
Won Suk Oh
April 31 Plastic Surgery Clinic, Seoul, Korea
,
Joo Heon Lee
April 31 Plastic Surgery Clinic, Seoul, Korea
› Author Affiliations

Background

This study aimed at overcoming the disadvantages of septal extension grafts and keeping the nasal tip as natural as possible by using different forms of the graft and additional supporting methods depending on the case.

Methods

Among 458 patients who received a septal extension graft from March 2008 to September 2011, 107 patients were selected who underwent at least a 6-month follow-up. Patients were categorized according to the primary objective of the operation; an upturned tip correction or tip lengthening, tip lengthening with tip projection, or retracted columella correction. Each group of patients received a different type of septal extension graft out of 3 different types of grafts based on the purpose of the operation. The evaluation of the results was made from by comparing preoperative and postoperative photographs of the tip angle, projection, and nasolabial angle.

Results

The average tip angle for the patients in the upturned tip correction group was reduced to 98.3 from 124.9 degrees. For the patients in the tip lengthening with tip projection group, the average tip angle was reduced to 96.8 from 122.4 degrees and the average tip projection was increased to 27.5 from 23.2 mm. The average nasolabial angle for the patients in the retracted columella correction group was increased to 94.6 from 74.8 degrees.

Conclusions

Sufficient nasal tip lengthening and projection could be achieved by applying a septal extension graft using the graft best suited for the group of patients categorized by surgical objective.



Publication History

Received: 10 May 2013

Accepted: 29 June 2013

Article published online:
02 May 2022

© 2014. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Kim JH, Oh WS, Park SW. et al. Various surgical procedures in the scale of upturned nose. J Korean Soc Aesthetic Plast Surg 2010; 16: 21-34
  • 2 Gunter JP, Rohrich RJ, Friedman RM. et al. Importance of the alar-columellar relationship. In: Gunter JP, Rohrich RJ, Adams Jr WP. Dallas rhinoplasty: nasal surgery by the masters. 2nd ed. St. Louis, MO: Quality Medical Pub.; 2007: 401-409
  • 3 Adamson PA, Morrow TA. The nasal hinge. Otolaryngol Head Neck Surg 1994; 111: 219-231
  • 4 Rohrich RJ, Hoxworth RE, Thornton JF. et al. The pyriform ligament. Plast Reconstr Surg 2008; 121: 277-281
  • 5 Kim JH, Park SW, Oh WS. et al. New classification for correction of alar retraction using the alar spreader graft. Aesthetic Plast Surg 2012; 36: 832-841
  • 6 Kim JH. Correction of upturned nose. In: Koeran Society of Rhinoplasty Surgeons. Current trends in Asian rhinoplasty: operation guide. Seoul: Koonja Publishing, Inc.; 2011: 349-369
  • 7 Oh SH, Kang NH, Woo JS. et al. Stabilization of unilateral septal extension graft using pivot locking suture. J Korean Soc Aesthetic Plast Surg 2008; 14: 156-160
  • 8 Tebbetts JB. Shaping and positioning the nasal tip without structural disruption: a new, systematic approach. Plast Reconstr Surg 1994; 94: 61-77
  • 9 Byrd HS, Andochick S, Copit S. et al. Septal extension grafts: a method of controlling tip projection shape. Plast Reconstr Surg 1997; 100: 999-1010
  • 10 Seyhan A, Ozden S, Ozaslan U. et al. A simplified use of septal extension graft to control nasal tip location. Aesthetic Plast Surg 2007; 31: 506-511
  • 11 Sen C, Iscen D. Caudal septal advancement for nasal tip projection and support in rhinoplasty. Aesthetic Plast Surg 2006; 30: 135-140
  • 12 Toriumi DM, Patel AB, DeRosa J. Correcting the short nose in revision rhinoplasty. Facial Plast Surg Clin North Am 2006; 14: 343-355
  • 13 Kim SK, Kim HS. Secondary Asian rhinoplasty: lengthening the short nose. Aesthet Surg J 2013; 33: 353-362
  • 14 Stovin JS. The importance of the membranous nasal septum. AMA Arch Otolaryngol 1958; 67: 540-541
  • 15 Han SK. Surgical anatomy of Korean nose. J Korean Soc Aesthetic Plast Surg 2005; 11: 1-9
  • 16 Jeong JY. Tripod framework rebuilding in Asian nose: tip plasty using alar advancement technique. J Korean Soc Aesthetic Plast Surg 2010; 16: 125-138
  • 17 Tebbets JB. Primary rhinoplasty: a new approach to the logic and the techniques. St. Louis, MO: Mosby; 1998
  • 18 Paik MH, Chu LS. Correction of the short nose using derotation graft. Arch Aesthetic Plast Surg 2012; 18: 35-44
  • 19 Mirastschijski U, Jokuszies A, Vogt PM. Skin wound healing: repair biology, wound, and scar treatment. In: Neligan PC. Plastic surgery. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2013: 267-296
  • 20 Bafaqeeh SA. Open rhinoplasty: effectiveness of different tripplasty techniques to increase nasal tip projection. Am J Otolaryngol 2000; 21: 231-237
  • 21 Kim JS, Han KH, Choi TH. et al. Correction of the nasal tip and columella in Koreans by a complete septal extension graft using an extensive harvesting technique. J Plast Reconstr Aesthet Surg 2007; 60: 163-170