Correction of the nasal tip and columella in Koreans by a complete septal extension graft using an extensive harvesting technique

Abstract

The nose of most Koreans is characterised by a low nasal dorsum, retracted columella, and an acute columella-labial angle. For the surgical correction of the tip and columella, a complete septal extension graft, along with augmentation rhinoplasty has been developed. However, the use of this type of graft is frequently problematic because the septal cartilage is not large enough. In a study involving 10 cadavers, a complete septal extension graft was achieved in two of them by using septal cartilage harvested according to standard techniques. Therefore, the septal cartilage was harvested, leaving a 5-mm L-shaped strut, and a complete septal extension graft was implanted. The present report describes the results obtained in 34 patients and offers an analysis of the results as judged by the columella-labial angle and three proportional indices (nose height index, nasal bridge length index, and nasal tip projection index), measured by photogrammetry. The postoperative values obtained in these four categories increased significantly compared to the preoperative ones, thus confirming that the projection of tip was augmented, the nose was lengthened, and the columella was advanced caudally. Moreover, these positive outcomes were maintained during long-term follow-up, and no side effects, such as saddle nose deformity, were reported.