Asian Septorhinoplasty: Septal L-Strut Extension Graft

By: Eun Sang Dhong

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Synopsis: This book presents the cutting edge in Asian septorhinoplasty using only autogenous tissue and explains how to achieve high-end results consistently. To date, dorsal alloplastic implants have predominated in Asian rhinoplasty, leading to iatrogenic complications such as a foreshortened nose and destruction of the remaining septum. The lower two-thirds of the nose can be enhanced anteriorly and caudally by means of septorhinoplasty using autogenous grafts only in Asians with relatively small noses. Septal L-strut extension, comprising a caudally extended septal batten graft and an anteriorly extended spreader graft, stabilizes and supports a septum-dependent dorsum and tip, reducing the need for alloplastic implants. The septal L-strut extension graft is indicated in primary cases when the bony dorsum is acceptable but the cartilaginous dorsum is relatively hypoplastic, and in secondary cases with an iatrogenic short-nose deformity due to alloplastic implants. The book describes this approach in detail and in addition presents autogenous solutions for the upper third of the nose and various specific circumstances.