Y-Shaped En-Bloc Mortise-Tenon Rhinoplasty Technique

Abstract

AbstractBackgroundNasal tip management is the most important and challenging aspect of rhinoplasty. Costal cartilage can be utilized in septal extension grafting to effectively correct nasal shape deformity.ObjectivesThe authors described their experience with costal cartilage grafting for septal extension utilizing a novel en-bloc mortise-tenon technique to correct primary or secondary nose deformity or to enhance nasal appearance in Asian patients.MethodsFrom July 2015 to December 2017, costal cartilage grafts were applied as septal extension biomaterials utilizing the novel en-bloc mortise-tenon technique in 278 consecutive Asian rhinoplasty patients with primary (n = 95), secondary (n = 173), and tertiary (n = 10) nose deformity or in patients needing nasal reshaping. The age of the patients ranged from 19 to 46 years. In all cases, the mucoperichondria of the nasal septum were dissected bilaterally from the septal cartilage. The prepared en-bloc costal cartilage graft was mounted onto the caudal portion of the septal cartilage and fixed to the septum with 5-0 polydioxanone sutures.ResultsThe follow-up duration ranged from 10 months to 2.5 years. Of the 278 patients treated, 5 were male and 273 were female. External lengthening of the nose from the nasal root to the tip ranged from 3 to 10 mm. All patients except 1 were satisfied with the shape of the nose.ConclusionsThe authors obtained good aesthetic results utilizing the novel en-bloc mortise-tenon method for connecting costal cartilage grafts as septal extension materials in patients with different types of nasal deformity and in patients needing nose reshaping.Level of Evidence: 4