Lengthening the short nose in Asians: key maneuvers and surgical results.

IMPORTANCE

Using objective anthropometric measurement, this study reports the outcome of surgical correction of short-nose deformities in Asian patients.

OBJECTIVE

To present our experience in lengthening the short nose in Asians and report the surgical results.

DESIGN, SETTING, AND PATIENTS: In this retrospective review, we study the cases of 36 patients who underwent surgical correction of short-nose deformity. The effect of nasal lengthening was analyzed using anthropometric measurement, including nasion to tip-defining point (N-TDP), nasal tip projection (NTP), nasofrontal angle (NFA), and columellar-facial angle (CFA).

EXPOSURES: Surgical correction of short-nose deformity.

MAIN OUTCOME MEASURES: The preoperative and postoperative N-TDP, NTP, NFA, and CFA and patient satisfaction.

RESULTS

The mean postoperative follow-up duration was 29.8 months. The cause of the short nose was congenital in 18 cases and secondary to previous rhinoplasty in 18 cases. Septal tissue, conchal cartilage, costal cartilage, and conchal composite tissue were used as graft materials. The key procedures for lengthening included septal extension graft reinforced with extended spreader, dorsal onlay, and tip grafts. The N-TDP increased by 11.2%, and CFA decreased from 122.6° to 111.1°. The NFA changed from 148.9° to 148.5°. The NTP ratio, measured using the Goode method, decreased from 0.53 to 0.50. The increase of N-TDP was greater in patients undergoing the costal cartilage grafting procedure than in those who received septal or conchal cartilage. All patients were satisfied with the aesthetic results, and there were no serious complications.

CONCLUSIONS AND RELEVANCE: In Asians, the key maneuvers for lengthening were septal extension graft reinforced with extended spreader and dorsal onlay graft. Rib cartilage provided superior lengthening effect compared with other cartilage.

LEVEL OF EVIDENCE: 4.