Secondary Asian Rhinoplasty: Lengthening the Short Nose

Abstract

Short nose deformity results from primary short nose, previous rhinoplasty, or trauma. A septal extension graft using rib cartilage can be placed to address this deformity. Indications for this procedure include previously damaged septal cartilage, innate septal issues, saddle nose deformity, skin problems, and secondary deformities of the cleft lip and nose. The authors describe their experience using rib cartilage grafts for septal extension to correct short nose deformity in Asian patients. From January 2005 through February 2010, the authors used a rib cartilage graft for septal extension in 38 consecutive Asian rhinoplasty patients with primary (n = 5) or secondary (n = 33) short nose deformity. In cases where the septum had been overresected in a previous rhinoplasty, a reinforcement procedure was performed using additional supportive rib cartilage grafts. The mean duration of follow-up was 2.5 years. Of the 38 treated patients, 7 were male and 31 were female (mean age, 28.5 years). A single septal extension graft with rib cartilage was used in 32 cases, whereas a double graft was used in 6 cases. The average external lengthening of the nose from nasal root to tip was 8 mm. All patients were satisfied with the shape of the lengthened nose. There was 1 case of pneumothorax, but complications were otherwise rare. Neither cartilage exposure nor infection was observed. The authors have obtained good aesthetic results using a rib cartilage graft for septal extension in the treatment of short nose. This technique may be particularly useful in cases where the septal cartilage is unavailable for harvest because of previous rhinoplasty or trauma.