Anatomical Nasal Tip Plasty with Autogenous Cartilage Graft

ABSTRACT

Augmentaion rhinoplasty is one of the most common aesthetic surgery in Korea. Plastic surgeons have been more interested in not only simple augmentation of nasal dorsum, but making more beautiful and natural nasal tip. In the people who has depressed nasal bridge with round and blunted tip, simple augmentation of the nasal dorsum with silicone or Gore-Tex implants could aggravate the tip's disfigurement, so the need for tip plasty has been more emphasized in those persons. There have been used two traditional techniques in endonasal autogenous cartilage tip graft for increasing tip projection, Sheen's shield graft and Peck's onlay graft. But these techniques have several disadvantages such as displacement, visibility of graft margin and flattening of infralobule. The most criticizable problem is that these grafts have limitation in producing the natural and anatomical tip contour.We have done 45 consecutive nasal tip plasties using anatomically-shaped cartilage grafts which was developed from the idea of combination of Sheen's shield and Peck's onlay graft. We followed up the patients from 2 to 14 months. Most patients have been very satisfied with the results and no serious complications were noted. Author's graft was designed to minimize displacement by stable placement on both alar domal and lobular segments, minimize graft visibility by increasing graft contact to nasal tip skin, manipulate the cephalo-caudal length by modification of onlay thickness, and most of all, reproduce the anatomical tip projection and contour.