LAUSR

Background The most challenging part of rhinoplasty is nasal tip management. For East Asian patients with a bulbous under projected nasal tip with thick skin, autologous cartilage is considered the gold-standard graft material to provide strong support to the nasal tip and effectively increase tip projection. The present study aimed to evaluate the outcomes of closed rhinoplasty with a mushroom-shaped costal cartilage graft in East Asian patients. Methods From February 2018 to May 2019, 52 patients underwent rhinoplasty with a mushroom-shaped costal cartilage graft in our institution. Rhinoplasty was performed through a bilateral endonasal incision. Postoperatively, all patients were photographed and asked to complete a satisfaction survey online or by telephone. Results The mean follow-up period was 15.8 months (range 12–21 months). Twenty-four of 52 patients agreed to participate in this study. Postoperatively, the mean nasofrontal angle was 137.7 ± 3.7°, mean nasolabial angle was 94.1 ± 6.2°, mean nasal tip angle was 79.4 ± 5.2°, and mean columellar/lobular angle was 44.7 ± 2.4°. The mean tip projection/nasal length index was 0.53 ± 0.07, and the mean columellar/lobular length index was 1.21 ± 0.22. There were no prolonged functional complications. Most patients (23/24; 95.8%) were satisfied with the aesthetic results. Conclusion The present results suggest that the mushroom-shaped costal cartilage graft in closed rhinoplasty is a good choice for the correction of a bulbous under projected nasal tip. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .