Bilateral Fan-Shaped Septal Extension Struts in East Asian Augmentation Rhinoplasty.

Abstract

For costal cartilage-based rhinoplasty, a method that could properly manage warping of the columellar strut graft and facilitate establishing a stable cartilaginous framework remains desirable. In this study, the authors present a new graft design named bilateral septal extension strut. It utilizes a pair of cartilage grafts with the shape of a fan, which are bilaterally fixated to the septum. Such "sandwiched" structure undertakes the combined functional roles of a columellar strut and a septal extension graft. Fifty-two female patients, ranging in age from 18 to 37years, received augmentation rhinoplasty surgery based on the bilateral septal extension strut. Among these patients, 20 of them were primary cases, 26 secondary, and other six cases were tertiary. Patients' own evaluations on the overall improvements in the nose rendered high satisfaction rate. There was no case of graft extrusion or infections. During the long-term follow-up, one case presented dorsal onlay graft warping and two cases presented in significant asymmetrical nostrils due to the deviation of the columellar at 12months postoperatively and were corrected in the revision surgery. The application of the bilateral septal extension struts can help mitigate the negative impact of strut graft warping, making it more manageable. As a result, reliable as well as sustainable support for both tip and lower lateral cartilages can be achieved in the long term. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .