Septal extension graft - nose and lip movement

Question

Hello doctors, i had a bad rhinoplasty and am planning to get a revision. My nose was shortened. I am seeking information about a septal extension graft. Does it necessarely make the tip of the nose rigid ? Also, does it limit lip movements ? More precisely, can it affect the smile ? Does it lenghten the upper lip ? Thank you for you anwers

Alejandro Nogueira, MD · Answer

A short nose, congenital or iatrogenic, indeed needs re-support by means of caudal push down; the most suitable and at the same time difficult option is the caudal extension grafts, simple or asociated with columelar L assembled strut graft. They need supply of ear, septal if available or in extreme cases rib cartilages. This is a maneuver very very few surgeons have experience with, either primare and way lesser in revision rhinoplasties, do research well. Online you'll find a lot of drawings and infographics but few real intraop images. Do seek prove of facts your surgeon has real experience dealing with short ethnic or revision rhinoplasties, essentially with intraop images of his skills.If well done and no complications arise, no issues happen afterwards and the lips are not affected, nasal elasticity is restored to normal.
If you wish better grounded opinion please do post or send privately well lit, focused and standard images: frontal, both lateral and both oblique views, also underneath the nostrils.
Feel free to request any additional information from me.

Jarrod Little, MD · Answer

Correcting  a short nose following Rhinoplasty can be difficult.  A septal extension graft can help, but it is still restricted by the overlying soft tissue.  Septal extension grafts are also often referred to as a columellar strut grafts.  There are many fine technical details that will affect the overall result in terms of nasal projection, tip support, and tip refinement.  They will often make the tip more rigid, but this is often needed if there is a loss of tip support.  They generally do not affect the smile or the length of the upper lip.  As always, it is important to personally consult with a board-certified Plastic Surgeon who specializes in Rhinoplasty.

Septal extension graft - nose and lip movement

Answers (2)

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