[Contracted Nose] Deep Analysis of Contracted Nose Correction Surgery, 5 Steps Part 03_ Fixation of the Relaxed Cartilage Structure

April 31 Plastic Surgery - Contracted Nose Correction, 5 Steps Part 03

Hello.

Today, we will continue with the deep analysis of the 5-step contracted nose correction procedure.

Part 03: Fixation of the relaxed cartilage structure

is the topic for today.

After carefully securing a thin skin flap and releasing the contracted, twisted cartilage structure, fixing it in a new position is somewhat easier than the previous two steps.

Depending on how the fixation is performed, the durability of the results after surgery, the frequency of complications, and the need for additional corrective surgery can be determined.

There are broadly four fixation methods.

↓ ↓ ↓

First, tip extension suture

Second, derotation graft

Third, septal extension graft

Fourth, rigid rib support

April 31 Plastic Surgery Contracted Nose Correction Surgery

Tip Extension Suture

(Tip extension suture)

Deep Analysis of Contracted Nose Correction Surgery, Step 5_Part.03

The tip extension suture was first presented by Dr. Kim Jae-hoon, the chief director, at the 2006 Korean Society of Aesthetic Plastic Surgery

and was later presented in 2015 in PRS, a global plastic surgery journal,

and is widely and usefully employed.

This method sutures the wide lateral portion of the extended alar cartilage (lower lateral cartilage) to the tip of the septum.

Its advantage is that it is very simple yet provides support, and it preserves the natural movement of the nasal tip.

Its limitation is that it can be used in patients with sufficient septal length or height for suturing, and when the shape or firmness of the alar cartilage is adequately preserved.

Derotation Graft

(Derotation graft)

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This method, devised by Dr. Baek Moo-hyun in Korea, places a small piece of cartilage behind the released alar cartilage structure and fixes it in place.

With a small piece of cartilage, it can provide very strong support, maintain the natural appearance of the nasal tip, and restore the function of the alar structure, that is, correct a pinched nose at the same time.

90% of visiting patients tend not to believe that a tip extension procedure or a derotation graft can be done with just a small piece of ear cartilage.

I think this is partly due to doctors who do not understand the technique insisting on the superiority of rib cartilage grafts.

I hope that incorrect information will gradually be corrected.

Septal Extension Graft

(Septal extension graft)

Deep Analysis of Contracted Nose Correction Surgery_ Part.03

A septal extension graft is a method of taking part of the septum or using other cartilage to extend the length of the septum.

Because the method is simple yet provides strong support, it is likely one of the most widely used surgical methods for nasal tip surgery in East Asians, who tend to have thick, firm skin.

The nasal tip can become somewhat stiff, but many methods have been developed to compensate for this, and now it is also widely used in plastic surgery and otolaryngology because it can simultaneously correct patients with a deviated septum.

This method has contraindications that should be understood. Because the septal area is part of the support structure that holds the center of the nose, if it is damaged by inflammation or other causes, there is a risk that the nose may collapse.

Although it was once thought to be a stable material, problems later occurred frequently, and now it is rarely used. Instead of materials such as Medpor, which are almost no longer used, autologous tissue must be used for the areas that go deep inside.

Rigid Rib Support

(Rigid rib support)

Deep Analysis of Contracted Nose Correction Surgery_Part.03

Lastly, this is the use of rib cartilage.

There are various ways to use it, and it is recognized as a material that must be used in contracted nose correction.

This is incorrect information.

Rib cartilage has abundant tissue and is firm, so it provides excellent support. However, a scar inevitably appears at the center of the body, and because it is relatively important protective tissue for vital organs, its use and amount should be limited.

Even when reconstruction can be sufficiently achieved with the ear, septum, or other methods, performing surgery with the idea of unconditionally harvesting rib cartilage and building only a strong skeletal framework with a large amount of it is like erecting only the external shape with a steel frame without considering the interior function or space.

Of course, when there is no other cartilage available to secure, rib cartilage must be used, and the amount should also be planned with function and texture in mind.

April 31 Plastic Surgery

Plastic surgery is a field of modern advanced medicine that improves quality of life by reconstructing parts of the body whose appearance or function is congenitally or acquiredly damaged or insufficient.

Even within the logic of the market economy, we will strive to be April 31 Plastic Surgery, contributing to improving quality of life through accurate information in the field of aesthetic plastic surgery.

Kim Jae-hoon, Chief Director of April 31 Plastic Surgery

April 31 Plastic Surgery

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