A New Technique in Asian Nasal Tip Plasty: Non-Incisional, Back-to-Back,
Bent Double-Layered Conchal Cartilage Extension Graft with Pagoda-Shaped
Onlay Graft
Abstract
Background: The columellar strut graft based on the use of back-to-back
autogenous conchal cartilage is one of the most commonly employed
invisible grafts used for nasal tip projection. This graft provides an
effective means of achieving nasal tip projection but is limited by its
flexibility, especially with respect to cephalic rotation. We designed
an effective technique that addresses these limitations. Method: A total
of 38 patients received a non-incisional, back-to-back, bent
double-layered conchal cartilage and pagoda-shaped onlay graft.
Projection and location of the nasal tip, nasal length, and nasolabial
angle were measured using lateral view photographs. Preoperative and
postoperative results were compared. Result: Preoperative and
postoperative nasal tip projection ratios and nasal tip location ratios
were significantly different. Revision surgery was not required in any
case and no direct graft-associated complication occurred. Conclusion:
We performed tip plasty with a modified columellar strut graft, that is,
a non-incisional, back-to-back, bent double-layered conchal cartilage
columellar strut graft. In most cases, this method resulted in a
significant tip projection increase.