The effect of caudal extension graft on nostril in rhinoplasty

Abstract

Caudal extension graft technique is a versatile technique in rhinoplasty providing good tip support and maintaining tip projection. In this study, we evaluated the clinical outcomes of this technique and performed anthropometric analysis of nostril shape from the basal view. Thirty-two patients undergoing caudal extension graft technique were identified from December 2011 to July 2016. Patients with a minimum of 12 month follow-up were included. Quantitative analysis was performed on standard pre- and postoperative photos. Nasal tip protrusion and columellar width were increased significantly (p value < 0.001), while apex angle was decreased significantly (p value <0.001). Caudal extension graft placement resulted in a non-significant decrease in nostril size on the side of graft placement. There was no significant change in columellar length or nostril width. Caudal extension graft technique is a versatile and reliable technique for addressing poor tip support and setting tip projection. Disadvantages of caudal extension graft include asymmetric nostrils and over projection in cases where projection reduction is needed. We showed that while there is a significant increase in columellar width, there is no significant increase in nostril asymmetry. Level of Evidence: Level IV, risk/prognostic study.