A new technique in Asian nasal tip plasty: Non-incisional double-layered conchal cartilage graft

Background: The columellar strut graft based on the use of back-to-back autogenous conchal cartilage is one of the most commonly employed invisible grafts used for nasal tip projection. This graft provides an effective means of achieving nasal tip projection but is limited by its flexibility, especially with respect to cephalic rotation. We designed an effective technique that addresses these limitations. Method: A total of 38 patients received augmentation rhinoplasty with non-incisionally bent double-layered conchal cartilage columellar strut graft with nasal tip onlay graft. Projection and location of the nasal tip, nasal length, and nasolabial angle were measured using lateral view photographs. Pre- and postoperative results were compared. Result: Pre- and postoperative nasal tip projection ratios and nasal tip location ratios were significantly different. Revision surgery was not required in any case and no direct graft-associated complication occurred. Conclusion: We performed tip plasty with a modified columellar strut graft, that is, a nonincisionally bent double-layered conchal cartilage columellar strut graft. In most cases, this method resulted in a significant tip projection increase. (C) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.