The Correction of Atypical Short Nose Due to Low Caudal Sellion Level: the Combination Method Using L-type Silastic Nasal Implant and Shield-shape Cartilage Graft

Kim, Sung Min

Abstract

The short nose is characterized by decreased distance from the starting point of nose, sellion to tip defining point and increased nasolabial angle with excessively increased nostril show. In Orientals there are many people who have short nose due to low caudal level sellion and small nasofrontal angle with low dorsum of nose, reduced tip projection and acute nasolabial angle although it is not a typical short nose. In this study we defined this nose as atypical short nose. Lengthening short nose is arguably the most difficult operation in aesthetic rhinoplasty. We have described here a simple and easy technique that correct atypical short nose by using L-type silastic nasal implant and shield-shape cartilage graft. From January 2002 to March 2004, the author attempted to lengthen nasal root by cephalic upward repositioning of sellion with L-type silastic nasal implant with open rhinoplasty approach and improve tip projection and cephalic rotation by using columellar srtut formation with L-type silastic nasal implant, interdomal suture and shield-shape cartilage graft which is harvested from concha in 18 cases. We have got the satisfactory results on aesthetic aspects in all patients without any complications. The change of nasal length was from 44.8mm to 45.7mm and nasal tip projection and cephalic rotation were successfully improved. Especially the patients were very satisfied with one's lateral nasal profile because of smooth curvature of nasal root and natural nasofrontal angle due to cephalic nasal lengthening by upward repositioning of sellion. In conclusion I think this procedure is an effective and simple method in correcting atypical short nose which is characterized by low caudal level sellion, low dorsum of nose and reduced tip projection in Orientals.