[2002.11.06] Nasal Tip Plasty Using Septal Cartilage

Date: November 6, 2002
Conference: 53rd Fall Meeting of the Korean Society of Plastic and Reconstructive Surgeons (Walkerhill Hotel)
Title: Nasal Tip Plasty Using Septal Cartilage

Background

The nasal tip in Asian patients frequently features weak projection, a flatter shape, unclear tip-defining points, and columellar retraction. These characteristics often stem from underdeveloped lower lateral cartilages and a high volume of fibrofatty tissue in the soft-tissue envelope. In modern practice, patient expectations extend beyond simply raising the nose to include sharper contours, properly shaped nostrils, and an aesthetically appropriate nasolabial angle. Traditional methods—often reliant on implants—have proven insufficient for achieving a refined, stable, and complication-free nasal tip.

Methods and Materials

Recognizing that weak cartilaginous structures typically form the core of these tip problems, the authors used septal cartilage (rather than synthetic implants) to reinforce the medial crura via a strut graft. This approach creates a stable, upright nasal tip framework. Depending on the desired rotation and projection, an onlay or shield graft—applied in single or multiple layers—further refines the tip’s shape.

Results

• Improved Tip Definition: Using the septal cartilage strut allowed for clearer tip contours.
• Better Nostril Orientation: The nostrils were redirected upward to a more ideal angle.
• Avoidance of Implant-Related Complications: Since the tip was constructed with autologous cartilage, complications commonly associated with silicone implants were minimized.
• Ideal for Revision Cases: In patients with prior implant issues, septal cartilage reconstruction offered an effective, biocompatible alternative.

Discussion

Asian noses often have lower profiles or broader tips, which makes implant-based tip plasty vulnerable to structural and complication-related issues. Employing a septal cartilage strut graft addresses these challenges directly, providing a more stable and aesthetically pleasing outcome. This approach is considered one of the most effective methods for correcting a weak nasal tip in Asian rhinoplasty.