Asian Septorhinoplasty Septal L-Strut Extension Graft

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.

Eun Sang Dhong, MD, Professor, Department of Plastic and Reconstructive Surgery, Guro Hospital, College of Medicine, Korea University