Boomerang Modification of the Septal Extension Graft: Graft Design and Functional Outcomes

R Daniel Peters; Milind Vasudev; Amir A Hakimi; Katelyn K Dilley; Theodore V Nguyen; Allison Hu; Brian J F Wong

doi:10.1089/fpsam.2023.0152

Boomerang Modification of the Septal Extension Graft: Graft Design and Functional Outcomes

Facial Plast Surg Aesthet Med. 2024 Jan 12. doi: 10.1089/fpsam.2023.0152. Online ahead of print.

Authors

R Daniel Peters¹, Milind Vasudev², Amir A Hakimi³, Katelyn K Dilley², Theodore V Nguyen², Allison Hu⁴, Brian J F Wong²

Affiliations

¹ Raleigh Capitol Ear, Nose, and Throat, Raleigh, North Carolina, USA.
² Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, California, USA.
³ Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.
⁴ Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, Palo Alto, California, USA.

PMID: 38215259
DOI: 10.1089/fpsam.2023.0152

Abstract

Background: A "boomerang" graft is an end-to-end caudal septal extension graft (SEG) that conforms to the geometry of the anterior septal angle, and avoids septal overlap, unlike a side-to-side SEG. Objective: To compare breathing improvements in rhinoplasty patients receiving boomerang SEGs and patients receiving side-to-side SEGs. Methods: Retrospective cohort analysis of patients undergoing rhinoplasty with either end-to-end boomerang SEG or a side-to-side SEG. Functional outcomes were assessed through the Nasal Obstruction Symptom Evaluation (NOSE) survey. Results: The boomerang SEG cohort had a mean age of 34 years and were 68% female compared with 38 years and 67% female in the side-to-side SEG cohort (p > 0.05). The cohorts did not differ in the proportion of the lateral crural tensioning, spreader graft placement, or history of rhinoplasty. The boomerang cohort demonstrated a 67% reduction in NOSE scores compared with a 70% reduction among the side-to-side SEG cohort (p = 0.14). Men undergoing boomerang graft placement reported significantly less postoperative functional improvement than men undergoing placement of a side-to-side SEG (62% vs. 77%, p = 0.01). Conclusion: Use of a boomerang graft is not likely to negatively affect rhinoplasty functional outcomes when compared with a side-to-side SEG.