Paradigm Shift in Rhinoplasty with Virtual 3D Surgery Software and 3D Printing Technology.

Most Asians have a nose with a short columella and a low dorsum; augmentation rhinoplasty using implants is commonly performed in Asian countries to achieve a taller and more well-defined nasal dorsum. However, the current knowledge is insufficient to fully understand the various subjective desires of patients, reflect on them during surgery, or to objectively analyze the results after surgery. Advances in digital imaging technologies, such as 3D printing and 3D scanning, have transformed the medical system from hospital-centric to patient-centric throughout the medical field.

Triple Strut Concept for the Nasal Tip Projection in Small Lower Lateral Cartilages and Septum.

Introduction: This study aimed to evaluate the effectiveness of the triple strut graft technique for nasal tip projection in Asian patients with weak and small lower lateral cartilages and septum. The technique uses a combination of septal angle strut and, columellar strut grafts and lateral crural repositioning to provide support for the nasal tip.

Methods: The study included 30 Asian patients who underwent primary rhinoplasty using this technique between January 2019 and December 2021.

Role of Derotation Suture in Bulbous Tip Correction in Asian Rhinoplasty.

In bulbous tip correction, consideration should be given to the presence of cephalic malposition of lower lateral cartilage as well as volume reduction. Derotation suture is a suture technique for tip lengthening but may contribute to bulbous tip correction through the caudal reposition of lower lateral cartilage.From 2016 to 2018, a total of 50 Asian patients underwent bulbous tip correction with derotation suture.

Cosmetic Augmentation Rhinoplasty for East Asians.

Symmetric pocket formation and meticulous implant carving are the most critical parts of nasal dorsal augmentation using implants. Innovative three-dimensional printed nasal implants can exactly fit the nasal dorsal contour, decreasing the chance of deviation and malpositioning. Vertically oriented folded dermal graft technique can avoid the high resorption rate of conventional dermofat grafts.

Correction of the deviated tip and columella in crooked nose.

The primary procedural components of deviated nose correction are as follows: osteotomy to correct bony deviation, septal deviation correction, manipulation of the dorsal septum to correct upper lateral cartilage deviation, and correction of functional problems (manipulation for correction of internal valve collapse and hypertrophy of the inferior turbinate). The correction of tip and nostril asymmetry cannot be overemphasized, because if tip and nostril asymmetry is not corrected, patients are unlikely to provide favorable evaluations from an aesthetic standpoint. Tip asymmetry, deviated columella, and resulting nostril asymmetry are primarily caused by lower lateral cartilage problems, which include deviation of the medial crura, discrepancy in the height of the medial crura, and asymmetry or deformity of the lateral crura.

Multilayered Costal Cartilage Graft for Nasal Dorsal Augmentation.

Background: Nasal dorsal augmentation is one of the most commonly performed rhinoplasty procedures in Asia. We describe our experience with multilayered costal cartilage grafting (MCG) for dorsal augmentation in Asian patients. We aimed to evaluate the aesthetic outcomes and complications of MCG in comparison with those of one-block concentric carving costal cartilage graft (OCG) using objective and subjective assessment criteria.

Dorsal Augmentation Using Autogenous Tissues.

Autogenous materials used for Asian dorsal augmentation are temporal fascia, dermofat, solid block type of costal cartilage, and diced cartilage. The temporal fascia is used for radix augmentation or correction of minor focal depression. Dermofat, solid block costal cartilage, and diced cartilage are recommended for major dorsal augmentation.

Correction of deviated nose.

Deviated nose deformities have always been a surgical challenge, and it is essential to achieve both functional and esthetic improvements. Various techniques have evolved over time to correct deviated noses but no one method applies in all cases. Successful correction requires a complete understanding of the various surgical techniques and concepts, including the three-dimensional nasal structure and the time-related changes to surgically-treated noses.

A Novel Technique of Asian Tip Plasty: Rein-Shaped Columellar Strut Graft.

Background: The columellar strut graft is one of the most commonly used invisible grafts in tip plasty techniques for nasal tip projection. However, the columellar strut graft induces cephalic rotation of the dome with nasal tip projection. This is an effective change in Western people with a long nose; however, this change should be avoided in Asians who have a relatively short nose and visible nostrils.

Use of Irradiated Homologous Costal Cartilage in Rhinoplasty: Complications in Relation to Graft Location.

Background: Nasal septal cartilage and conchal cartilages are preferred sources of grafts in augmentation rhinoplasty. Rib cartilage can also be used, but it may evoke a patient's concerns about a scar and an extensive surgery. In such cases, irradiated homologous costal cartilage (IHCC) can be a useful alternative.

Augmentation Rhinoplasty With Silicone Implant Covered With Acellular Dermal Matrix.

Background: Alloplastic materials are a mainstay in Asian rhinoplasty. However, the outline of alloplastic implants can become conspicuous over time in rhinoplasty patients, which is a significant cause for revision. In revision rhinoplasty, alloplastic materials can remain a viable and affordable option in Asian patients.

A Novel Technique for Short Nose Correction: Hybrid Septal Extension Graft.

Background: There are many techniques for correcting short nose deformities and the septal extension graft is the most commonly performed technique among Asians. In many Asian patients septal cartilage, however, is too small and insufficient to perform an effective septal extension graft. Therefore, we designed a novel technique, named hybrid septal extension graft to overcome this pitfall in Asian tip plasty.

Effective Use of a Silicone-induced Capsular Flap in Secondary Asian Rhinoplasty.

Performing secondary rhinoplasty in patients who underwent primary rhinoplasty using a silicone implant is difficult due to thinning of nasal skin and formation of a capsule. Excess capsule formation can cause capsular contracture, resulting in short nose deformity or implant deviation, migration, or implant demarcation. Revision rhinoplasty using a capsular flap, dorsal silicone implant, and tip plasty was performed in 95 Korean patients (91 women and 4 men; mean age, 27 years) who previously underwent primary augmentation rhinoplasty using silicone implants.

L-shaped columellar strut in East asian nasal tip plasty.

Background: Nasal tip support is an essential consideration for rhinoplasty in East Asians. There are many techniques to improve tip projection, and among them, the columellar strut is the most popular technique. However, the conventional design is less supportive for rotating the tip.

A 2-year follow-up of irradiated homologous costal cartilage used as a septal extension graft for the correction of contracted nose in Asians.

Background: Septal extension graft is a useful method for the correction of contracted nose. When septal or costal cartilage is not available, irradiated homologous costal cartilage (IHCC) may be an alternative choice. This preliminary study is focused on noninfective absorption and other complications and postoperative changes of nasal length after septal extension graft using IHCC.