Septum-based nasal tip plasty : A comparative study between septal extension graft and double-layered conchal cartilage extension graft.

Background: Septal extension graft is currently the most commonly used primary and secondary rhinoplasty technique in Asia because it provides maximal tip projection and rotational controllability. We designed this study to compare the tip projection amount and rotational controllability of the tip support between the septal extension graft based on the L-strut septum and double-layered conchal cartilage graft based on the full septum at the nasal tip. Method: A total 27 consecutive patients who underwent nasal tip plasty with the septal extension graft or double-layered conchal cartilage graft for purely esthetic reasons between March 2014 and July 2016. The nasal tip projection and columellar labial angle in preoperative (T0), immediate postoperative (T1, average 2 weeks after the operation), and postoperative (T2, on average 7 months after the operation) was analyzed with clinical photography Result: 14 patients (Group A) received septal extension graft whereas 13 patients (Group B) received double-layered conchal cartilage graft. 61% and 74% changes in tip projection ratio were immediately achieved and was maintained after surgery for Groups A and B, respectively (T2-T0/T1-T0; p = 0.722 for Group A and B). Therefore, the relapse ratio of this technique was 39% and 26% for Groups A and B. Conclusion: This comparative study between the septal extension graft and double-layered conchal cartilage graft showed that both nasal tip plasties are similar in terms of stability. Considering the fact that the double-layered conchal cartilage graft could preserve septal support, this technique could become an effective and safe alternative option for rhinoplasty. (C)2017American Society of Plastic Surgeons

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