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J Cosmet Med 2017; 1(1): 8-15

Published online June 30, 2017

https://doi.org/10.25056/JCM.2017.1.1.8

Nasal tip surgery: nasal lengthening and augmentation in Asian rhinoplasty

Dong-Hak Jung, MD, PhD1, Kar-Su Tan, MD2, Sang-Gyun Jin, MD1

1Shimmian Rhinoplasty Clinic, Seoul, Korea, 2The Rhinoplasty Clinic, Singapore

Correspondence to :
Sang-Gyun Jin, Shimmian Rhinoplasty Clinic, Gangnam-daero 375, 6th Floor, Gangnam-gu, Seoul 06620, Korea
Tel: 82-2-523-3222, Fax: 82-2-523-3221, E-mail: shimmian@gmail.com

Received: January 2, 2017; Revised: March 21, 2017; Accepted: March 29, 2017

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Nasal tip surgery is the most important surgical procedure in rhinoplasty. Various surgical techniques have been introduced, however, in Asian rhinoplasty, nasal lengthening and augmentation are important in these days. The authors aimed to compile and review various tip techniques based on the 25 years of experience of the senior author. The authors reviewed and shared our thoughts on various nasal tip techniques with a focus on both a nasal lengthening and tip augmentation. There has been advancement in our understanding of the nasal anatomy and its relation to form. To share our knowledge led to new and improved techniques for manipulating the nasal tip. Rhinoplasty is a dynamic and continually advancing field, and the quest for the most efficient and effective technique continues.

Keywords: rhinoplasty, nasal tip, asian rhinoplasty, nasal lengthening, graft materials, nasal augmentation

  1. Kridel RW, Ashoori F, Liu ES, Hart CG. Long-term use and follow-up of irradiated homologous costal cartilage grafts in the nose. Arch Facial Plast Surg 2009;11:378-94.
    Pubmed CrossRef
  2. Lefkovits G. Irradiated homologous costal cartilage for augmentation rhinoplasty. Ann Plast Surg 1990;25:317-27.
    Pubmed CrossRef
  3. Demirkan F, Arslan E, Unal S, Aksoy A. Irradiated homologous costal cartilage: versatile grafting material for rhinoplasty. Aesthetic Plast Surg 2003;27:213-20.
    Pubmed CrossRef
  4. Suh MK, Ahn ES, Kim HR, Dhong ES. A 2-year follow-up of irradiated homologous costal cartilage used as a septal extension graft for the correction of contracted nose in Asians. Ann Plast Surg 2013;71:45-9.
    Pubmed CrossRef
  5. Kim J, Kim J, Uhm KI, Shin D, Kim S, Kim C, et al. Secondary cleft nasal deformity correction using bioabsorbable mesh. J Craniofac Surg 2016;27:1143-6.
    Pubmed CrossRef
  6. Razmpa E, Saedi B, Mahbobi F. Augmentation rhinoplasty with combined use of Medpor graft and irradiated homograft rib cartilage in saddle nose deformity. Arch Iran Med 2012;15:235-8.
    Pubmed
  7. Peled ZM, Warren AG, Johnston P, Yaremchuk MJ. The use of alloplastic materials in rhinoplasty surgery: a meta-analysis. Plast Reconstr Surg 2008;121:85e-92e.
    Pubmed CrossRef
  8. Gentile P, Bottini DJ, Cervelli V. Reconstruction of the nasal dorsum with Medpor implants. J Craniofac Surg 2007;18:15068.
    Pubmed CrossRef
  9. Kim YH, Kim BJ, Jang TY. Use of porous high-density polyethylene (Medpor) for spreader or extended septal graft in rhinoplasty: aesthetics, functional outcomes, and long-term complications. Ann Plast Surg 2011;67:464-8.
    Pubmed CrossRef
  10. McCurdy JA Jr. The Asian nose: augmentation rhinoplasty with L-shaped silicone implants. Facial Plast Surg 2002;18:245-52.
    Pubmed CrossRef
  11. Jang TY, Choi YS, Jung YG, Kim KT, Kim KS, Choi JS. Effect of nasal tip surgery on asian noses using the transdomal suture technique. Aesthetic Plast Surg 2007;31:174-8.
    Pubmed CrossRef
  12. Jin HR, Won TB. Nasal tip augmentation in Asians using autogenous cartilage. Otolaryngol Head Neck Surg 2009;140:526-30.
    Pubmed CrossRef
  13. Kridel RW, Scott BA, Foda HM. The tongue-in-groove technique in septorhinoplasty. A 10-year experience. Arch Facial Plast Surg 1999;1:246-56; discussion 257-8.
    Pubmed CrossRef
  14. Shah AR, Miller PJ. Structural approach to endonasal rhinoplasty. Facial Plast Surg 2006;22:55-60.
    Pubmed CrossRef
  15. Foda HM. Management of the droopy tip: a comparison of three alar cartilage-modifying techniques. Plast Reconstr Surg 2003;112:1408-17; discussion 1418-21.
    Pubmed CrossRef
  16. Datema FR, Lohuis PJ. Tongue-in-groove setback of the medial crura to control nasal tip deprojection in open rhinoplasty. Aesthetic Plast Surg 2015;39:53-62.
    Pubmed CrossRef
  17. Lohuis PJ, Datema FR. Patient satisfaction in Caucasian and Mediterranean open rhinoplasty using the tongue-in-groove technique: prospective statistical analysis of change in subjective body image in relation to nasal appearance following aesthetic rhinoplasty. Laryngoscope 2015;125:831-6.
    Pubmed CrossRef
  18. Guyuron B, Varghai A. Lengthening the nose with a tongueandgroove technique. Plast Reconstr Surg 2003;111:1533-9;discussion 1540-1.
    Pubmed CrossRef
  19. Toriumi DM. New concepts in nasal tip contouring. Arch Facial Plast Surg 2006;8:156-85.
    Pubmed CrossRef
  20. Margulis A, Harel M. Management of severe tip ptosis in closed rhinoplasty: the horizontal columellar strut. J Plast Reconstr Aesthet Surg 2007;60:400-6.
    Pubmed CrossRef
  21. Shah A, Pfaff M, Kinsman G, Steinbacher DM. Alar-columellar and lateral nostril changes following tongue-in-groove rhinoplasty. Aesthetic Plast Surg 2015;39:191-8.
    Pubmed CrossRef
  22. Kim CH. A new concept in the tip plasty of Asian rhinoplasty:the flag technique by use of only a septal cartilage. Plast Reconstr Surg 2015;135:1033-6.
    Pubmed CrossRef
  23. Celik M, Cayonu M, Comoglu S, Kanliada D. Figure-of-Eight suspension suture in open technique septorhinoplasty. J Craniofac Surg 2016. doi: 10.1097/SCS.0000000000002990. [Epub ahead of print]
    CrossRef
  24. Robotti E, Choc IS, Jaber O. Use of the “Septal T” as a spacer and conformer for a properly contoured nasal tip in rhinoplasty. Aesthet Surg J 2017. doi: 10.1093/asj/sjw104. [Epub ahead of print]
    CrossRef
  25. Seyhan A, Ozden S, Ozaslan U, Sir E. A simplified use of septal extension graft to control nasal tip location. Aesthetic Plast Surg 2007;31:506-11; discussion 512-3.
    Pubmed CrossRef
  26. Jung DH, Chang GU, Shan L, Liu DL, Wang ZJ, Tian HJ, et al. Pressure necrosis of septal cartilage associated with bilateral extended spreader grafts in rhinoplasty. Arch Facial Plast Surg 2010;12:257-62.
    Pubmed CrossRef
  27. Jung DH, Loh I. The “X-graft” for nasal tip surgery. Plast Reconstr Surg 2011;128:79e-80e.
    Pubmed CrossRef
  28. Jung DH, Joshi A, Chang GU, Ramachandra R, Hyun SM. Lapping of costal cartilage technique: a key step in stabilizing and reducing the bulk of costal cartilage used in rhinoplasty. JAMA Facial Plast Surg 2015;17:153-5.
    Pubmed CrossRef
  29. Quatela VC, Sherris DA, Johnson CM Jr. Skin excision revision rhinoplasty. Arch Otolaryngol Head Neck Surg 1993;119:542-6.
    Pubmed CrossRef
  30. Jung DH, Kwak ES, Kim HS. Correction of severe alar retraction with use of a cutaneous alar rotation flap. Plast Reconstr Surg 2009;123:1088-95.
    Pubmed CrossRef

Article

Review Article

J Cosmet Med 2017; 1(1): 8-15

Published online June 30, 2017 https://doi.org/10.25056/JCM.2017.1.1.8

Copyright © Korean Society of Korean Cosmetic Surgery.

Nasal tip surgery: nasal lengthening and augmentation in Asian rhinoplasty

Dong-Hak Jung, MD, PhD1, Kar-Su Tan, MD2, Sang-Gyun Jin, MD1

1Shimmian Rhinoplasty Clinic, Seoul, Korea, 2The Rhinoplasty Clinic, Singapore

Correspondence to:Sang-Gyun Jin, Shimmian Rhinoplasty Clinic, Gangnam-daero 375, 6th Floor, Gangnam-gu, Seoul 06620, Korea
Tel: 82-2-523-3222, Fax: 82-2-523-3221, E-mail: shimmian@gmail.com

Received: January 2, 2017; Revised: March 21, 2017; Accepted: March 29, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nasal tip surgery is the most important surgical procedure in rhinoplasty. Various surgical techniques have been introduced, however, in Asian rhinoplasty, nasal lengthening and augmentation are important in these days. The authors aimed to compile and review various tip techniques based on the 25 years of experience of the senior author. The authors reviewed and shared our thoughts on various nasal tip techniques with a focus on both a nasal lengthening and tip augmentation. There has been advancement in our understanding of the nasal anatomy and its relation to form. To share our knowledge led to new and improved techniques for manipulating the nasal tip. Rhinoplasty is a dynamic and continually advancing field, and the quest for the most efficient and effective technique continues.

Keywords: rhinoplasty, nasal tip, asian rhinoplasty, nasal lengthening, graft materials, nasal augmentation

References

  1. Kridel RW, Ashoori F, Liu ES, Hart CG. Long-term use and follow-up of irradiated homologous costal cartilage grafts in the nose. Arch Facial Plast Surg 2009;11:378-94.
    Pubmed CrossRef
  2. Lefkovits G. Irradiated homologous costal cartilage for augmentation rhinoplasty. Ann Plast Surg 1990;25:317-27.
    Pubmed CrossRef
  3. Demirkan F, Arslan E, Unal S, Aksoy A. Irradiated homologous costal cartilage: versatile grafting material for rhinoplasty. Aesthetic Plast Surg 2003;27:213-20.
    Pubmed CrossRef
  4. Suh MK, Ahn ES, Kim HR, Dhong ES. A 2-year follow-up of irradiated homologous costal cartilage used as a septal extension graft for the correction of contracted nose in Asians. Ann Plast Surg 2013;71:45-9.
    Pubmed CrossRef
  5. Kim J, Kim J, Uhm KI, Shin D, Kim S, Kim C, et al. Secondary cleft nasal deformity correction using bioabsorbable mesh. J Craniofac Surg 2016;27:1143-6.
    Pubmed CrossRef
  6. Razmpa E, Saedi B, Mahbobi F. Augmentation rhinoplasty with combined use of Medpor graft and irradiated homograft rib cartilage in saddle nose deformity. Arch Iran Med 2012;15:235-8.
    Pubmed
  7. Peled ZM, Warren AG, Johnston P, Yaremchuk MJ. The use of alloplastic materials in rhinoplasty surgery: a meta-analysis. Plast Reconstr Surg 2008;121:85e-92e.
    Pubmed CrossRef
  8. Gentile P, Bottini DJ, Cervelli V. Reconstruction of the nasal dorsum with Medpor implants. J Craniofac Surg 2007;18:15068.
    Pubmed CrossRef
  9. Kim YH, Kim BJ, Jang TY. Use of porous high-density polyethylene (Medpor) for spreader or extended septal graft in rhinoplasty: aesthetics, functional outcomes, and long-term complications. Ann Plast Surg 2011;67:464-8.
    Pubmed CrossRef
  10. McCurdy JA Jr. The Asian nose: augmentation rhinoplasty with L-shaped silicone implants. Facial Plast Surg 2002;18:245-52.
    Pubmed CrossRef
  11. Jang TY, Choi YS, Jung YG, Kim KT, Kim KS, Choi JS. Effect of nasal tip surgery on asian noses using the transdomal suture technique. Aesthetic Plast Surg 2007;31:174-8.
    Pubmed CrossRef
  12. Jin HR, Won TB. Nasal tip augmentation in Asians using autogenous cartilage. Otolaryngol Head Neck Surg 2009;140:526-30.
    Pubmed CrossRef
  13. Kridel RW, Scott BA, Foda HM. The tongue-in-groove technique in septorhinoplasty. A 10-year experience. Arch Facial Plast Surg 1999;1:246-56; discussion 257-8.
    Pubmed CrossRef
  14. Shah AR, Miller PJ. Structural approach to endonasal rhinoplasty. Facial Plast Surg 2006;22:55-60.
    Pubmed CrossRef
  15. Foda HM. Management of the droopy tip: a comparison of three alar cartilage-modifying techniques. Plast Reconstr Surg 2003;112:1408-17; discussion 1418-21.
    Pubmed CrossRef
  16. Datema FR, Lohuis PJ. Tongue-in-groove setback of the medial crura to control nasal tip deprojection in open rhinoplasty. Aesthetic Plast Surg 2015;39:53-62.
    Pubmed CrossRef
  17. Lohuis PJ, Datema FR. Patient satisfaction in Caucasian and Mediterranean open rhinoplasty using the tongue-in-groove technique: prospective statistical analysis of change in subjective body image in relation to nasal appearance following aesthetic rhinoplasty. Laryngoscope 2015;125:831-6.
    Pubmed CrossRef
  18. Guyuron B, Varghai A. Lengthening the nose with a tongueandgroove technique. Plast Reconstr Surg 2003;111:1533-9;discussion 1540-1.
    Pubmed CrossRef
  19. Toriumi DM. New concepts in nasal tip contouring. Arch Facial Plast Surg 2006;8:156-85.
    Pubmed CrossRef
  20. Margulis A, Harel M. Management of severe tip ptosis in closed rhinoplasty: the horizontal columellar strut. J Plast Reconstr Aesthet Surg 2007;60:400-6.
    Pubmed CrossRef
  21. Shah A, Pfaff M, Kinsman G, Steinbacher DM. Alar-columellar and lateral nostril changes following tongue-in-groove rhinoplasty. Aesthetic Plast Surg 2015;39:191-8.
    Pubmed CrossRef
  22. Kim CH. A new concept in the tip plasty of Asian rhinoplasty:the flag technique by use of only a septal cartilage. Plast Reconstr Surg 2015;135:1033-6.
    Pubmed CrossRef
  23. Celik M, Cayonu M, Comoglu S, Kanliada D. Figure-of-Eight suspension suture in open technique septorhinoplasty. J Craniofac Surg 2016. doi: 10.1097/SCS.0000000000002990. [Epub ahead of print]
    CrossRef
  24. Robotti E, Choc IS, Jaber O. Use of the “Septal T” as a spacer and conformer for a properly contoured nasal tip in rhinoplasty. Aesthet Surg J 2017. doi: 10.1093/asj/sjw104. [Epub ahead of print]
    CrossRef
  25. Seyhan A, Ozden S, Ozaslan U, Sir E. A simplified use of septal extension graft to control nasal tip location. Aesthetic Plast Surg 2007;31:506-11; discussion 512-3.
    Pubmed CrossRef
  26. Jung DH, Chang GU, Shan L, Liu DL, Wang ZJ, Tian HJ, et al. Pressure necrosis of septal cartilage associated with bilateral extended spreader grafts in rhinoplasty. Arch Facial Plast Surg 2010;12:257-62.
    Pubmed CrossRef
  27. Jung DH, Loh I. The “X-graft” for nasal tip surgery. Plast Reconstr Surg 2011;128:79e-80e.
    Pubmed CrossRef
  28. Jung DH, Joshi A, Chang GU, Ramachandra R, Hyun SM. Lapping of costal cartilage technique: a key step in stabilizing and reducing the bulk of costal cartilage used in rhinoplasty. JAMA Facial Plast Surg 2015;17:153-5.
    Pubmed CrossRef
  29. Quatela VC, Sherris DA, Johnson CM Jr. Skin excision revision rhinoplasty. Arch Otolaryngol Head Neck Surg 1993;119:542-6.
    Pubmed CrossRef
  30. Jung DH, Kwak ES, Kim HS. Correction of severe alar retraction with use of a cutaneous alar rotation flap. Plast Reconstr Surg 2009;123:1088-95.
    Pubmed CrossRef

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