Use of a Space Graft in Rhinoplasty

Abstract

Background: Construction of the nasal tip strut is an important part of rhinoplasty; the incidence of postoperative complications is closely related to the type of graft and the approach to cartilaginous framework construction. Objectives: To introduce a supplementary graft to support the cartilaginous framework. Methods: Forty patients (37 female and 3 male), aged from 18 to 40 years (average 29), received a rhinoplasty using a spacer graft. Of these, 12 were primary cases and the other 28 had a previous rhinoplasty procedure. Postoperatively, all patients were photographed and asked to complete a satisfaction survey. Complications were collected retrospectively. Results: Postoperatively, the mean nasofrontal angle was 141.92±1.26 degrees for the primary cases and 140.75±2.22 degrees for the repeat procedures; the mean nasolabial angle was 88.69±0.95 degrees for primary cases and 89.14±0.93 degrees for the repeat procedures; mean nasal length was 4.78±0.05 cm for primary cases and 4.79±0.07 cm for the repeat procedures; mean tip projection was 4.68±6.35 cm for primary cases and 2.24±0.07 cm for the repeat procedures. Self-report of the overall improvements showed a high satisfaction rate. One case (2.5%) had a postoperative complication involving a mildly deviated columellar. Conclusions: The spacer graft can be used as an effective supplement to the traditional methods for reconstructing the nasal tip framework; it can prevent the occurrence of postoperative complications such as the exposure of the nasal prosthesis, the downward rotation of the nasal tip, the depression of the supratip regions of the nose, and the deviation of the nasal columella.