A Modified Large-Cap Graft in East Asian Revision Rhinoplasty

Aesthetic Plast Surg. 2022 Oct;46(5):2378-2386. doi: 10.1007/s00266-022-02912-9. Epub 2022 May 16.

Abstract

Background: Reconstructing a well-defined nasal tip is a big challenge for East Asian patients, especially with nasal tip irregularities or short noses in revision rhinoplasty. This study aims to report our experience with a modified large-cap graft for improving the contour of the nasal tip in revision rhinoplasty.

Methods: A retrospective review was conducted for 91 patients (81 females, 10 males; mean age, 26.8 ± 6.7 years) who underwent revision rhinoplasty with a modified large-cap graft. The rhinoplasty outcome evaluation (ROE) was used for investigating patient satisfaction. The aesthetic outcomes were assessed by preoperative and postoperative photographs by two blinded plastic surgeons using the Independent Rhinoplasty Outcome Score.

Results: Most patients reported satisfactory aesthetic outcomes with overall ROE score increasing from preoperative 11.66 ± 3.98 to postoperative 17.30 ± 5.03 (p < 0.001). The doctors' evaluations on the improved contour of the nose rendered an overall score of 3.77 ± 0.42. The complication rate was 3.3% (pleural tear, 1.1%; hypertrophic scar, 2.2%) at the donor site, and 7.7% at the recipient site (warping, 3.3%; extrusion, 1.1%; deviation, 2.2%; infection, 1.1%). No other complications were observed during follow-up.

Conclusions: Large-cap graft may be safe and efficient for reconstructing contour of the nasal tip in revision rhinoplasty for East Asian patients.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Cap graft; Columellar strut graft; Costal cartilage; Dorsal onlay graft; Rhinoplasty; Septal extension graft.

MeSH terms

  • Adult
  • Esthetics
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Nasal Septum / surgery
  • Retrospective Studies
  • Rhinoplasty* / adverse effects
  • Treatment Outcome
  • Young Adult