Complications of Septal Extension Grafts in Asian Patients

Abstract

IMPORTANCE Nasal tip-plasty is one of the most important and difficult parts of rhinoplasty. Three-dimensional positioning of the nasal tip is a vital component in the overall appearance of the tip. The use of a septal extension graft (SEG) is a versatile technique that can supply nasal tip support and aid in positioning of the tip, as well as provide projection and lengthening. However, complications with this method can occur, and the incidence of these issues has risen with the increased use of this technique. OBJECTIVE To investigate the problems resulting from nasal tip surgical procedures using an SEG. DESIGN, SETTING, AND PARTICIPANTS This study involved a retrospective review of 44 consecutive patients who underwent nasal tip-plasty using an SEG. Patient results were analyzed with medical record review, patient questionnaires, and preoperative and postoperative photographs. Anthropometric measurements and analysis were performed for the pre- and postoperative tip projection and nasolabial angle. MAIN OUTCOMES AND MEASURES Prevalence of different complications of SEGs in Asian patients. RESULTS Eighty-six percent of the patients who had SEGs were satisfied with the cosmetic appearance of their nasal tip. Septal cartilage was the most frequently used material for SEGs. Complications in patients who had SEGs included nasal tip stiffness (45.5%), a decrease of projection (45.5%), nasal tip deviation (11.4%), and infection (4.5%). The revision rate was 9.0%. CONCLUSIONS AND RELEVANCE Asian nasal tip-plasty using an SEG can result in successful outcomes, providing nasal tip support, projection, and length. However, care needs to be taken to prevent complications such as hardness, loss of projection, nasal tip deviation, and infection.