Controlling Nasal Length with Extended Spreader Grafts: A Reliable Technique in Primary Rhinoplasty |
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Authors: | José M Palacín Francisco G Bravo Romau Zeky Hardy Schwarze |
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Institution: | (1) Teknon Hospital, Barcelona, Spain;(2) Cirugia Plastica y Reparadora, Hospital Universitario 12 de Octubre, Avd. de Cordoba s/n, E 28041 Madrid, Spain |
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Abstract: | Background The short nose characterized by a reduced distance from the nasal radix to the tip represents a challenging deformity in facial
plastic surgery. Several techniques have been described in the literature for augmentation of the short nose, but none emphasizes
the surgical maneuvers necessary to preserve nasal length in primary rhinoplasty and to avoid the development of a short nose
deformity.
Methods The authors present a surgical technique for avoiding postoperative nasal shortness and for controlling nasal length in primary
rhinoplasty. The procedure uses caudally extended bilateral spreader grafts, which prevent postoperative cephalic tip rotation
and allow control of tip rotation. The grafts should be placed electively in noses that have the potential to become overshortened
postoperatively. By doing so, surgeons can perform any of the common surgical maneuvers in rhinoplasty without risking short
nose deformity. The study included 41 patients with a mean age of 27 years who were considered to be at high risk for the
development of postoperative short nose deformity. All the patients were treated with bilateral extended spreader grafts via
the open nasal approach. The follow-up period was up to 12 months, with regular evaluation of the surgical outcome comprising
measurement of the nasal length and photographic analysis.
Results All the patients showed preserved nasal length after surgery with well-proportioned facial features. There was no evidence
of postoperative nasal shortening after 12 months of follow-up evaluation. No operative or postoperative complications were
detected. All the patients were pleased with the surgical results achieved.
Conclusion The use of extended spreader grafts during primary rhinoplasty for selected patients represents a valuable tool for preventing
short nose deformity after primary rhinoplasty. |
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Keywords: | Extended spreader grafts Nasal length Primary rhinoplasty Short nose deformity |
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