Comparative Analysis and Long-Term Results of Various Septal Extension Graft Types

Abstract

Shape, tip projection, and position can be controlled by the use of septal extension grafts (SEG). A retrospective cohort study of patients undergoing primary and secondary rhinoplasty was reviewed. The purpose of this study was to analyze maintenance of nasal length, dorsal length, and nasolabial angle postoperatively comparing different types of SEG using standardized photography and digital measurement. Two-hundred twenty-one patients undergoing rhinoplasty were included. There was a statistically significant change regarding the nasolabial angle during the time of follow-up decreasing from 97.53 to 95.30 degrees. No changes could be found in dorsal and nasal length. There was no significant difference among the techniques used to fixate the SEG. The nasolabial angle appeared to decrease from the position 2 weeks postoperatively without changes in the dorsal and nasal length. This means that the decrease in the nasolabial angle depends on the swelling effect and not on drooping of the tip confirming the reliability of SEG over time.

Keywords

septal extension graft - rhinoplasty - tongue in groove - double-layered conchal graft

• References

• 1 Gubisch W, Eichhorn-Sens J. The sliding technique: a method to treat the overprojected nasal tip. Aesthetic Plast Surg 2008; 32 (05) 772-778
• 2 Dobratz EJ, Tran V, Hilger PA. Comparison of techniques used to support the nasal tip and their long-term effects on tip position. Arch Facial Plast Surg 2010; 12 (03) 172-179
• 3 Gruber RP, Chang E, Buchanan E. Suture techniques in rhinoplasty. Clin Plast Surg 2010; 37 (02) 231-243
• 4 Toriumi DM. Discussion: septum-based nasal tip plasty: a comparative study between septal extension graft and double-layered conchal cartilage extension graft. Plast Reconstr Surg 2018; 141 (01) 57-58
• 5 Byrd HS, Andochick S, Copit S, Walton KG. Septal extension grafts: a method of controlling tip projection shape. Plast Reconstr Surg 1997; 100 (04) 999-1010
• 6 Akkus AM, Eryilmaz E, Guneren E. Comparison of the effects of columellar strut and septal extension grafts for tip support in rhinoplasty. Aesthetic Plast Surg 2013; 37 (04) 666-673
• 7 Guyuron B, Varghai A. Lengthening the nose with a tongue-and-groove technique. Plast Reconstr Surg 2003; 111 (04) 1533-1539 , discussion 1540–1541
• 8 Haack S, Gubisch W. Reconstruction of the septum with an autogenous double-layered conchal L-strut. Aesthetic Plast Surg 2014; 38 (05) 912-922
• 9 Erol O, Buyuklu F, Koycu A, Bas C, Erbek SS. Evaluation of nasal tip support in septorhinoplasty. Aesthetic Plast Surg 2019; 43 (04) 1021-1027
• 10 Han K, Jin HS, Choi TH, Kim JH, Son D. A biomechanical comparison of vertical figure-of-eight locking suture for septal extension grafts. J Plast Reconstr Aesthet Surg 2010; 63 (02) 265-269
• 11 Kim MH, Choi JH, Kim MS, Kim SK, Lee KC. An introduction to the septal extension graft. Arch Plast Surg 2014; 41 (01) 29-34