LAUSR

BACKGROUND Due to the small and weak septal cartilage of Asians, it's a challenge to obtain ideal tip projection and nose lengthening by septal extension graft using only septal cartilage. OBJECTIVES This study was aim to introduce a septal extension graft complex using nasal septal cartilage and the perpendicular plate of ethmoid (PPE) bone as well as bilateral auricular cartilage, and examine its effectiveness in terms of morphological and mechanical support. METHODS Septal cartilage was harvested under an endoscope according to standard techniques. Two pieces of PPE were placed on either side of the "L" strut, served as two spreader grafts. A double-layer of auricular cartilage was fixed as columellar strut grafts. Three-dimensional facial scanning was used to examine the change of three parameters. Nasal tip resistance was evaluated by a digital Newton meter. RESULTS A total of 25 patients were followed up over a mean postoperative duration of 25.9 months. The analysis showed significant differences in both contour parameters and nasal resistance; nasal length (41.4±4.0 vs 46.2±3.4 mm, p<0.05) and nasal tip projection (21.3±3.2 vs 24.4±2.7 mm, p<0.05) appeared to increase postoperatively, while nasolabial angle (117.6±5.9° vs 109.5±5.3°, p<0.05) showed a significant decrease after surgery. The resistance of the nasal tip also increased significantly (p < 0.05) at the displacement of 1mm, 2mm, and 3mm. All patients were satisfied with the aesthetic results, and no serious complications occur. CONCLUSIONS This kind of modified SEG technique can effectively adjust nasal morphology for short-nose East Asians.