Abstract
BACKGROUND: The insertion of implants and tip plasties have 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 because of inappropriate manipulation of the lower lateral cartilage and/or silicone capsular contracture. This study aimed to investigate the effectiveness and utility of applying a 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. METHODS: The authors prospectively studied 37 patients with a minimum follow-up of 12 months among 53 patients who underwent secondary rhinoplasty, including LCSG, between January of 2016 and December of 2020. The results were assessed using the Rhinoplasty Outcome Evaluation scale preoperatively and more than 12 months postoperatively. RESULTS: Two cases of asymmetric nostril and tip, 1 visible LCSG (bulging) and 1 external SS score, was 30.41 preoperatively and 75.90 postoperatively ( P < 0.001). All subgroups of tip deformities exhibited increased Rhinoplasty Outcome Evaluation scores after the surgery, with the subgroup demonstrating the highest change being "lateral crural deformities," and the lowest change being "tip deviation" ( P < 0.005). CONCLUSION: 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 appearance, symmetry, and external valve function, and can also lengthen the contracted nose.