X-shaped Tip Graft: A Versatile Solution for Warping Correction in Rib Cartilage-Based Rhinoplasty

An enduringly stable tip graft is the key to achieving successful rhinoplasty. However, the intrinsic tendency of rib grafts to warp renders the long-term outcome of cartilage-based rhinoplasty highly unpredictable. The aim of this study was to detail and validate the utilization of a tip graft that...

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Veröffentlicht in:Aesthetic surgery journal 2023-01, Vol.43 (1), p.26-36
Hauptverfasser: Wu, Lehao, You, Jianjun, Wang, Huan, Tian, Le, Xu, Yihao, Zheng, Ruobing, Zhang, Xulong, Guo, Junsheng, Fan, Fei
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container_end_page 36
container_issue 1
container_start_page 26
container_title Aesthetic surgery journal
container_volume 43
creator Wu, Lehao
You, Jianjun
Wang, Huan
Tian, Le
Xu, Yihao
Zheng, Ruobing
Zhang, Xulong
Guo, Junsheng
Fan, Fei
description An enduringly stable tip graft is the key to achieving successful rhinoplasty. However, the intrinsic tendency of rib grafts to warp renders the long-term outcome of cartilage-based rhinoplasty highly unpredictable. The aim of this study was to detail and validate the utilization of a tip graft that is characterized by a circumferential split on the tip graft, which creates a shape similar to the letter X. The counterrotating force applied intraoperatively and the complications that arose were examined retrospectively. Three-dimensional stereophotogrammetric evaluations of patients was performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, tip rotation, and the nasion-pronasale angulation. Forty-five female patients, ranging in age from 18 to 41 years (average, 28.5 years) completed the study. In all cases, the X graft was applied as an essential element for enhancing tip projection. Postoperative analysis showed excellent maintenance of tip position over time, evidenced by insignificant changes in nasion-pronasale angulation. Other postoperative evaluations, including tip projection, nasal length, and nasolabial angle, showed significant improvement. The differences were not statistically different between short- and long-term follow-up. The X graft effectively mitigates the negative impact of graft warping. It is the ultimate form for tip support and for elongating short noses. It has the merits of versatility and flexibility when used to create a strong and sustainable tip support in East Asian rhinoplasty.
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However, the intrinsic tendency of rib grafts to warp renders the long-term outcome of cartilage-based rhinoplasty highly unpredictable. The aim of this study was to detail and validate the utilization of a tip graft that is characterized by a circumferential split on the tip graft, which creates a shape similar to the letter X. The counterrotating force applied intraoperatively and the complications that arose were examined retrospectively. Three-dimensional stereophotogrammetric evaluations of patients was performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, tip rotation, and the nasion-pronasale angulation. Forty-five female patients, ranging in age from 18 to 41 years (average, 28.5 years) completed the study. In all cases, the X graft was applied as an essential element for enhancing tip projection. Postoperative analysis showed excellent maintenance of tip position over time, evidenced by insignificant changes in nasion-pronasale angulation. Other postoperative evaluations, including tip projection, nasal length, and nasolabial angle, showed significant improvement. The differences were not statistically different between short- and long-term follow-up. The X graft effectively mitigates the negative impact of graft warping. It is the ultimate form for tip support and for elongating short noses. It has the merits of versatility and flexibility when used to create a strong and sustainable tip support in East Asian rhinoplasty.</description><identifier>ISSN: 1090-820X</identifier><identifier>EISSN: 1527-330X</identifier><identifier>DOI: 10.1093/asj/sjac170</identifier><identifier>PMID: 35748855</identifier><language>eng</language><publisher>England</publisher><subject>Adolescent ; Adult ; Cartilage - transplantation ; Female ; Humans ; Nasal Septum - surgery ; Nose - surgery ; Retrospective Studies ; Rhinoplasty - adverse effects ; Rhinoplasty - methods ; Ribs ; Treatment Outcome ; Young Adult</subject><ispartof>Aesthetic surgery journal, 2023-01, Vol.43 (1), p.26-36</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. 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However, the intrinsic tendency of rib grafts to warp renders the long-term outcome of cartilage-based rhinoplasty highly unpredictable. The aim of this study was to detail and validate the utilization of a tip graft that is characterized by a circumferential split on the tip graft, which creates a shape similar to the letter X. The counterrotating force applied intraoperatively and the complications that arose were examined retrospectively. Three-dimensional stereophotogrammetric evaluations of patients was performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, tip rotation, and the nasion-pronasale angulation. Forty-five female patients, ranging in age from 18 to 41 years (average, 28.5 years) completed the study. In all cases, the X graft was applied as an essential element for enhancing tip projection. 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source MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection
subjects Adolescent
Adult
Cartilage - transplantation
Female
Humans
Nasal Septum - surgery
Nose - surgery
Retrospective Studies
Rhinoplasty - adverse effects
Rhinoplasty - methods
Ribs
Treatment Outcome
Young Adult
title X-shaped Tip Graft: A Versatile Solution for Warping Correction in Rib Cartilage-Based Rhinoplasty
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