Lateral Margin Graft for Minimizing Visible Lateral Margin on Radix Using Autologous Rib Cartilage in Asian Rhinoplasty

Abstract

BackgroundVisible lateral margin after rhinoplasty is considered one of the potential complications. PurposeThe purpose is to assess the suitability of implementing a lateral margin graft (LMG) to mitigate the occurrence of a visible lateral margin (VLM) during augmentation rhinoplasty with autologous rib cartilage.Study Design, Setting, Sample: This is a retrospective cohort study between January 2016 and April 2022 in a private clinic. The inclusion criteria were patients who underwent augmentation rhinoplasty for aesthetic purposes using autologous rib cartilage. Patients who received allogenic tissue grafts or alloplastic materials, those with systemic diseases, and pregnant or breastfeeding females were excluded. Predictor variableThe primary predictor variable is the implementation or non-implementation of a LMG. Main outcome variablesThe primary outcome variable is the aesthetic satisfaction and the degree of minimization of the VLM when LMG is implemented and when it is not. Therefore, to understand the aesthetic satisfaction, the author used the Rhinoplasty Outcome Evaluations questionnaire (ROE), and to understand the degree of minimization of the VLM, the author measured the Lateral margin visibility score (LMVS) using a 5-Point Likert scale score. CovariatesThe evaluated covariates included sex, age at surgery, number of previous rhinoplasties, purpose of surgery and postoperative complications. AnalysesThe data were analyzed using the Independent Samples T-test, Paired T-test, Oneway ANOVA test. A significance level of P< 0.05 was employed for all statistical analyses. ResultsA total of 69 consecutive patients were included in the study, divided into Group 1(21 patients without LMG) and Group 2(48 patients with LMG). Postoperative ROE scores increased by 15.31±4.03 in Group 1 and 22.60±6.77 in Group 2 compared to preoperative ROE scores(P<0.001). In the patients’ LMVS, Group 1 had a score of 2.48±0.81, while Group 2 had a score of 3.06±0.76 points(P=0.009). In the surgeons’ LMVS, surgeon 1 indicated scores of 2.38±0.74 and 2.94±0.89 points, respectively(P=0.007). Furthermore, surgeon 2 indicated scores of 2.28±0.72 and 2.90±0.83 points, respectively(P=0.002). ConclusionWhen performing rhinoplasty using autologous rib cartilage, the use of a LMG can minimize the visible lateral margin, which increases patient satisfaction and the surgical completeness.