Nasal Tip Surgery in Asians

Abstract

Objective The authors intended to review our surgical techniques used in Asian tip surgery and to suggest effective techniques, according to the types of the nasal tip that are addressed. Methods 107 patients who had nasal tip surgery from Jan. 2005 to Dec. 2006 in a tertiary hospital were enrolled in the study. Medical records, graphic operation records, and standardized patient photographs were retrospectively reviewed. Initial diagnosis, types of nasal tip surgery, associated operative techniques, surgical results and complications were analyzed. Results Initial diagnosis included deviated nose, hump nose, combine deviated and saddle nose, low profile nose, short nose, and cleft nose deformity, in order of frequency. Nasal tip surgery included augmentation of projection, control of rotation, restoration of symmetry and volume reduction, among which augmentation was used in all cases. External approach was used in 74% and intranasal approach in 26%. For augmentation of the tip projection, onlay grafts (39%), septal extension grafts (25%), and tip modifying suture with onlay grafts (20%) were the most commonly used methods. Infection or extrusion of the grafts was not found. Complications included tip deviation due to the deviation of the septal extension graft in 1 case, visible tip graft in 1 case, and slight upward rotation of the tip in 1 case. Conclusions In Asians, augmentation of the tip projection is the main issue in tip surgery and is best performed with cartilage onlay grafts or septal extension graft rather than suture modification.