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Hybrid septal extension graft for short nose correction
- 1. Man Koon Suh, M.D. How to overcome troublesome obstacle inHow to overcome troublesome obstacle in Asian short nose:Asian short nose: Hybrid Septal Extension GraftHybrid Septal Extension Graft JW Plastic Surgery Center, Seoul, Korea AMERICAN SOCIETY OF PLASTIC SURGEONS PLASTIC SURGERY 2013
- 2. Septal extension graft <Extended spreader type> <Batten type>
- 5. Hybrid septal extension graft
- 7. IHCC
- 9. caudal septum IHCC septal cartilage graft
- 10. septal cartilage conchal cartilage
- 12. Periods: Feb. 2010 ~ Mar. 2013 Cases:57 (Primary cases: 42 / Secondary contracted cases: 15)
- 13. Results
- 14. Nasal lengthening:3mm ~ 10mm Complications:0 - infection: 0 - resorption: 0 - warping: 0 - asymmetric tip and columella: 0 Revision: 3 - 2 cases: too long tip - 1 case: low tip
- 17. caudal septum IHCC septal cartilage graft IHCC septal cartilage
- 18. <POD #5 months>
- 22. <Preop> <Postop>
- 23. <Preop> <Postop>
- 24. <Preop> <Postop>
- 26. <Preop> <POD #1 yr>
- 27. <Preop> <POD #1 yr>
- 28. Advantages of hybrid septal extension graft 1. Even small septal cartilage can be utilized 2. Can avoid donor site morbidity from use of ….autogenous rib cartilage 3. Compared to IHCC use alone - Tip is more mobile - Deformity is much smaller in case IHCC is resorbed unexpectedly
- 29. - A very small septal cartilage, the most common obstacle of Asian short nose correction, can be overcome by: hybrid septal extension grafthybrid septal extension graft Conclusion
- 30. Thank you
Notes de l'éditeur
- Good afternoon, everyone. I am Dr. Suh, from JW plastic surgery center in Seoul, Korea. Today’s my topic is how to overcome troublesome obstacle in Asian short nose: Hybrid septal extension graft
- As you can see in screen, septal extension graft is the most commonly performed procedure for the short nose correction. For this, we need a certain length of septal cartilage.
- However, very small and insufficient septal cartilage in Asian patient is common, which makes it difficult to do a septal extension graft effectively
- Even though autogenous rib cartilage can be a alternative option, it can leave a scar on chest wall and some patients do not want a somewhat big surgery.
- However, I have developed the HSEG.
- Carve the irradiated homologous costal cartilage into a shape of thin batten, and securely fix them to caudal septum bilaterally. Harvested septal cartilage should be located between the two IHCC batten grafts and fixed with sutures. Fix the alar cartilage at the end of septal cartilage graft. Ear cartilage could be used as an alternative to IHCC. If the septal cartilage is exceptionally small, septal cartilage can be pulled more caudally without touching the caudal septum. If you look at 2nd pictures, there is a gap.
- This is a acutual procedure. A pair of IHCC is fixed to caudal septum bilaterally.
- And septal cartilage is fixed between them.
- When the sepal cartilage is exceptionally small or the amont of lengthening is very large, then septal cartilage is located more caudally not touching the caudal septum
- Ren jing ru사진, 배지은, 조희경 것도 있으니 참조할 것, Ear cartilage could be used as an alternative to IHCC
- This is an
- During a 3 year period, I performed 57 operations, primary 42, secondary contracted 15.
- And results were:
- Nasal lenghening was between 3 mm and 10 mm. I had zero complications with this procedure(up), though 3 clients asked for a slight revision(down).
- This is an example of this procedure. She has had 3 times of operation before and now she has contracted short nose with too much visible nostril.
- She has silicone implant and contracted capsule was removed. But her septal cartilaee is too small.
- Hybrid spetal extension graft as I explained already. SC is not touching the caudal septum.
- Preop. And postop. View. You can see lengthened nasal lenth and decreased nostril show.
- Oblique view
- Lateral view
- This is another case. As you can see, he has short nose with too much visible nostril.
- This is preoop. And postop. view
- This is a contracted case. She…..
- This is a before and after picture. Now(up),as you can see on the right, nose has been Lengthened and nostril show corrected.
- Side view.
- In conclusion,