Versatile Usability of Lateral Crural Strut Graft for Correction of Various Nasal Tip Deformity in Secondary Rhinoplasty in Asians.

Abstract

The insertion of implants and tip plasties has been performed in Asian patients for an attractive and higher nasal profile, which can result in diverse tip deformations such as notching, pinching, alar retraction, incompetent external valve, deviated tip, cephalic rotation, and lateral crus malposition due to inappropriate manipulation of the lower lateral cartilage and/or silicone capsular contracture. This study aimed to investigate the effectiveness and utility of applying lateral crural strut graft (LCSG) as a consistent and appropriate surgical method to correct various nasal tip deformities that occur as complications following rhinoplasty in Asian patients. We prospectively studied 37 patients with a minimum follow-up of 12 months among 53 patients who underwent secondary rhinoplasty, including LCSG, between January 2016 and December 2020. The results were assessed using a Rhinoplasty Outcome Evaluation preoperatively and more than 12 months postoperatively. Two cases of asymmetric nostril and tip, one visible LCSG (bulging), and one external valve insufficiency were noted, with no other major complications. The overall mean ROE score was 30.41 preoperatively and 75.90 postoperatively (P<.001). All subgroups of tip deformities exhibited increased ROE scores after the surgery, with the subgroup demonstrating the highest change being "Lateral crural deformities," and with the lowest change being "Tip deviation" (P<.005). In Asian patients, LCSG using autogenous cartilage would be a useful and versatile option for various types of nasal tip deformities in secondary rhinoplasty, which can effectively improve tip cosmesis, symmetry, external valve function, and can also lengthen the contracted nose.