Facial Plast Surg
DOI: 10.1055/s-0041-1726025
Original Research

Caudal Extension Graft of the Lower Lateral Cartilage: Technique and Aesthetic and Functional Results

Juliano de Oliveira Sales
1  Department of Otorrinolaringology, Mater Dei Rede de Saúde, Belo Horizonte, Minas Gerais, Brazil
,
Wolfgang Gubisch
2  Department of Facial Plastic Surgery, Marien Hospital Stuttgart, Stuttgart, Baden-Württemberg, Germany
,
Rodrigo Ribeiro Ferreira Duarte
1  Department of Otorrinolaringology, Mater Dei Rede de Saúde, Belo Horizonte, Minas Gerais, Brazil
,
Aline Souza Costa Teixeira Moreno
1  Department of Otorrinolaringology, Mater Dei Rede de Saúde, Belo Horizonte, Minas Gerais, Brazil
,
Felipe Marques de Oliveira
1  Department of Otorrinolaringology, Mater Dei Rede de Saúde, Belo Horizonte, Minas Gerais, Brazil
,
Lorena Martins de Oliveira Coura
3  Pontificia Universidade Catolica de Minas Gerais, Medical School, Belo Horizonte, Minas Gerais, Brazil
› Author Affiliations

Abstract

Here we describe a new technique to deal with alar retraction, a highly undesirable imperfection of the nose. The procedure involves placing a caudal extension graft below the vestibular portion of the lower lateral cartilage (LLC) after its detachment from the vestibular skin. The graft is fixed to the cartilage and, subsequently, to the vestibular tissue. The present retrospective study included 20 patients, 11 females and 9 males, with a mean age of 28.90 years. Follow-up ranged from 1 to 18 months. Surgery improved alar notching to a smoother dome shape and nostril exposure was reduced in every patient. The caudal extension graft of the LLC contributed to rise in overall patient satisfaction, as revealed by the postoperative increase of the Rhinoplasty Outcomes Evaluation (ROE) mean score from 40.0 to 79.17 (p < 0.0001). It also contributed to and improved functional outcomes, as indicated by the decrease of the Nasal Obstruction Symptom Evaluation (NOSE) mean score from 52.75 to 13.25 (p = 0.0001). Sex did not affect the mean ROE and NOSE scores. Thus, increased patient satisfaction measured by the ROE is present in both sexes and at both age groups but it is better detected in the first year after surgery. Functional improvements analyzed with NOSE are best detected in patients aged ≥ 30 years and in follow-ups of 11 months. The caudal extension graft of the LLC technique described herein effectively and safely corrects alar retraction and the collapse of the nasal valve while filling the soft triangle.



Publication History

Publication Date:
14 April 2021 (online)

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