A Novel Technique for Short Nose Correction: Hybrid Septal Extension Graft

Background: There are many techniques for correcting short nose deformities and the septal extension graft is the most commonly performed technique among Asians. In many Asian patients septal cartilage, however, is too small and insufficient to perform an effective septal extension graft. Therefore, we designed a novel technique, named hybrid septal extension graft to overcome this pitfall in Asian tip plasty. Methods: From February 2010 to March 2013, 41 patients with primary (N - 30) or secondary (N - 11) short nose deformity underwent a hybrid septal extension graft. The hybrid septal extension graft is a modified septal extension graft which uses the small septal cartilage along with irradiated homologous costal cartilage. Irradiated homologous costal cartilage was carved into a shape of a thin batten and securely fixed bilaterally to the caudal septum. Harvested septal cartilage was located between the 2 irradiated homologous costal cartilage batten grafts and fixed with sutures. Then, the alar cartilage was fixed at the end of the septal cartilage graft. The nasal lengths, nasal tip projections, and nasolabial angles were measured pre- and postoperatively. Results: The hybrid septal extension graft showed enough nose lengthening and a decreased nostril show, even in cases with a very small septal cartilage. Conclusions: The authors present a novel technique for correction of short nose deformity in Asians. The hybrid septal extension graft provides good results with minimal complications and overall patient satisfaction was very high.