Closed Rhinoplasty with a Mushroom-Shaped Costal Cartilage Graft in East Asian Patients

Background The most challenging part of rhinoplasty is nasal tip management. For East Asian patients with a bulbous under projected nasal tip with thick skin, autologous cartilage is considered the gold-standard graft material to provide strong support to the nasal tip and effectively increase tip projection. The present study aimed to evaluate the outcomes of closed rhinoplasty with a mushroom-shaped costal cartilage graft in East Asian patients. Methods From February 2018 to May 2019, 52 patients underwent rhinoplasty with a mushroom-shaped costal cartilage graft in our institution. Rhinoplasty was performed through a bilateral endonasal incision. Postoperatively, all patients were photographed and asked to complete a satisfaction survey online or by telephone. Results The mean follow-up period was 15.8 months (range 12-21 months). Twenty-four of 52 patients agreed to participate in this study. Postoperatively, the mean nasofrontal angle was 137.7 +/- 3.7 degrees, mean nasolabial angle was 94.1 +/- 6.2 degrees, mean nasal tip angle was 79.4 +/- 5.2 degrees, and mean columellar/lobular angle was 44.7 +/- 2.4 degrees. The mean tip projection/nasal length index was 0.53 +/- 0.07, and the mean columellar/lobular length index was 1.21 +/- 0.22. There were no prolonged functional complications. Most patients (23/24; 95.8%) were satisfied with the aesthetic results. Conclusion The present results suggest that the mushroom-shaped costal cartilage graft in closed rhinoplasty is a good choice for the correction of a bulbous under projected nasal tip.