To answer the increased demand for augmentation rhinoplasty, particularly in Asian demographics, a shift from autogenous materials to synthetic implants like silicone and expanded polytetrafluoroethylene has been witnessed. These materials present an increased risk of complications like infection, extrusion, capsular contracture, and dissatisfaction. This study focuses on a case of revision rhinoplasty in a 48-year-old patient with a previous silicone implant and propose an innovative approach in managing the implant capsule. The use of the existing capsule as a mechanical and biological support structure for the diced cartilage graft in dorsal reconstruction showcases a promising method to mitigate risks and improve outcomes in revision surgeries. The capsule around the silicone is biologically active and provides a good environment for the cartilage graft to survive and improve the healing process. This approach tends to minimize the dissection to avoid potential revision complications like skin necrosis, fibrotic tissue, and infections.

Introduction: Augmentation rhinoplasty traditionally represents a serious challenge for plastic surgeons. The association with centrofacial lipofilling is a great approach to achieve harmonious, aesthetic results. The aim of this article is to describe our personal association between Augmentation Rhinoplasty and Centrofacial Lipofilling (ARCL) in non-Caucasian patients. Materials and Methods: In this study, we retrospectively reviewed patients treated with ARCL at our institution between January 2019 and December 2023. We described our personal approach and technique. At a minimum follow-up time of one year, post-operative pictures were taken, and patients were reassessed, evaluating aspects such as global symmetry, shape and contour of the nose, and facial harmony and rejuvenation; finally, patients\' satisfaction was investigated according to the ROE questionnaire and the modified S-GAIS. Results: A total of 307 patients were included in the study. They reported a significant satisfactory aesthetic result in nasal image and facial harmony, as the mean postoperative ROE and S-GAIS score show. None of the grafts extruded or collapsed. Wounds healed without reported major infection. Conclusions: This study has demonstrated that ARCL is a safe approach that contributes to improve functional and aesthetic outcomes, has a high patient satisfaction rate, and limited post-operative complications.

Augmentation rhinoplasty or commonly known as \"nose jobs\" is one of the most common plastic surgical procedures aimed to improve cosmetic appearance. This procedure is considerably safer, less time consuming with faster recovery and immediate cosmetic effect. This procedure needs of highly experienced and well-trained plastic surgeon. According to facial analysis you can select the type of rhinoplasty. Open discussion with the patient to select appropriate surgical technique and its possible risks with your plastic surgeon to ensure the highest level of safety and satisfaction. Autologous grafting materials are safe, efficient and also the first choice for rhinoplasty due to it can survive without a vascular supply, the resorption rate of cartilage is much lower than that of a bone graft. Autologous grafting materials are stable and resistant to infection and extrusion over time so, they are successfully used for dorsal augmentation. To perform successful augmentation rhinoplasty, surgeons should be highly experienced and well-trained and augmentation materials that are currently available and understand their risks, benefits and uses. Autologous cartilage graft regarded as the graft of choice in augmentation rhinoplasty because of their lower rate of infection, rejection, resorption, extrusion, donor site morbidity, easy reshaping.

Enhancing nasal tip projection is an important objective in Asian rhinoplasty. Nasal tip enhancement using auricular cartilage is simple and suitable for Asian patients. However, the long-term retraction problem of the auricular framework still needs to be solved for optimal results.
The authors propose a modified auricular cartilage framework construction technique that provides stronger long-term support to the nasal tip and columellar base.
Eighty-one patients underwent augmentation rhinoplasty between January 2016 and December 2019. The cymba and cavum conchae were harvested from one ear in all cases. The cymba concha was carved and folded to form a caudal septal extension graft (CSEG). The cavum concha was divided into an integrated cap/shield graft and a columella base graft. The columella base graft was diced into particles in size of 1 mm3, and inserted into the gap between CSEG, anterior nasal spine, and the medial crus to strengthen the foundation. The nasal profile was analyzed before the operation and at least 12 months after the operation. The patient satisfaction score was assessed 12 months after surgery.
Patients were followed up for 12-36 months. The nasal tip projection from both the lateral and basal views was significantly improved. The columella-labial angle was increased from 83.15° (6.20°) to 96.50° (7.40°) (p < 0.05). The nostril tip proportion increased from 0.83 (0.14) to 1.17(0.16) (p < 0.01). A stable long-term outcome was achieved.
With the modified framework construction technique, long-term nasal tip drooping can be prevented. This method can be a practical choice for Asian patients seeking augmentation rhinoplasty.

OBJECTIVE: to better reconstruct the nasal shape after cleft lip repair with 3D printing assisted autologous costal cartilage augmentation rhinoplasty, especially for patients with radix augmentation needs.
METHODS: 20 patients with nasal deformity secondary to cleft lip repair and radix augmentation needs had received surgical treatment from July 2016 to November 2021. A total of 10 cases were treated with autologous costal cartilage augmentation rhinoplasty for nasal deformity after cleft lip repair, and 10 cases were treated with the help of 3D printing. According to the characteristics of nasal deformity, autologous costal cartilage was carved and implanted into the nose back.
RESULTS: 3D printing assisted autologous costal cartilage augmentation in the treatment of nasal deformity after cleft lip repair, the incision healed well, and there were no complications in the thoracic cartilage donor area. The shape of the nose is satisfactory, the height and shape of the nose tip and the size of both nostrils are mostly symmetrical, the nasal columella is elongated, the original nose tip is flat, the collapse of the nose wing is satisfactory, and the nose lip angle is close to normal.
CONCLUSIONS: 3D printing assisted autologous costal cartilage augmentation is an ideal treatment for nasal deformity after cleft lip repair.

The subdorsal cantilever graft (SDCG) is a costal cartilage graft that is positioned below the nasal dorsum to control the position of the nasal bones and middle nasal vault. SDCG type A is used to raise the middle nasal vault and caudal nasal bones to correct the saddle nose deformity. SDCG type B can be used to raise the entire dorsum of the nose (radix, bony vault, and middle vault) in the ethnic augmentation rhinoplasty patient. This article will discuss the indications and technique of the SDCG in dorsal preservation rhinoplasty.

UNASSIGNED: We investigated the satisfaction and nasal airway function of patients who underwent L-shaped augmentation rhinoplasty using rhinoplasty outcomes evaluation (ROE). Nasal obstruction was evaluated using the nasal obstruction symptom evaluation (NOSE) and peak nasal inspiratory flowmeter (PNIF) score. We explored the correlation between tip projection, ROE, NOSE, and PNIF scores.
UNASSIGNED: We conducted a pre-and post-experimental study of 16 adult Indonesian patients who underwent L-shaped augmentation rhinoplasty. We used the neurotic scale to rule out patients with body dysmorphic disorder (BDD), and patients with low-to-moderate neurotic scores were included as participants.
UNASSIGNED: For all patients who underwent augmentation rhinoplasty, the median score of the NOSE questionnaire decreased from 12.5 to 5 after surgery (P = .005). The ROE median satisfaction scores also increased from 7.00 to 14.00 postoperatively (P = .001). The median PNIF preoperative score increased from 92 (70-130) to 115 (105-155) postoperatively. There was an increase in tip projection from 1.5 (1.1-2) preoperative to 2.05 (1.8-2.5) postoperative. There was a significant correlation between ∆ tip projection and ∆ NOSE (P = .048), with a moderate correlation (r = .502). However, there was no significant correlation between ∆ tip projection and ∆ PNIF (P = .080) and ∆ ROE (P = .302).
UNASSIGNED: The increase in ROE and PNIF, and the decrease in NOSE score after surgery revealed that the augmented L-shaped rhinoplasty technique has high satisfaction rates in both the nasal esthetics and functions of patients. The tip projection increment was proven to elevate nasal function subjectively in a certain range of tip height difference evaluated by the NOSE score.

BACKGROUND: Various techniques with different grafts and implants have been proposed to establish a smooth and symmetric nasal dorsum with adequate function. Broadly, two categories of materials have been used in this regard: alloplastic implant materials and autograft materials. The aim of these meta-analyses is to explore the incidence of complications after dorsum augmentation surgery using alloplastic materials.
METHODS: After duplication removal 491 papers remained that title and abstract were assessed for eligibility. Regarding the study type, 27 observational studies were included, 21 retrospective and 6 prospective case series. A total of 3803 cases were enrolled in this systematic review and meta-analysis.
RESULTS: Twenty-seven articles reported on complications and outcomes of dorsal augmentation rhinoplasty with synthetic materials. In a random-effects model, the weighted mean percentage was 2.75% (95% CI 1.61 to 4.17%). the weighted mean percentage were 1.91% (95% CI 0.77 to 3.54%), 0.72% (95% CI 0.316 to 1.31%), and 0.78% (95% CI 0.43 to 1.24%) respectively.
CONCLUSIONS: The widely used alloplasts were expanded polytetrafluoroethylene (ePTFE), high-density polyethylene, and silicone. The total rates for complications, infection, deviation, irregularity, hematoma, extrusion, and overcorrection were 2.75%, 1.91%, 0.72%, 0.70%, 0.78%, and 0.49%, respectively. The revision rate, based on the random effects model, was 6.40% with 95%CI (3.84 to 9.57).
BACKGROUND: This meta-analysis was registered at the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42020209644 ).

BACKGROUND: Correction of saddle nose deformity is one of the most frequently sought surgeries by patients seeking rhinoplasty in Asian countries. Nasal dorsal augmentation always requires graft material to achieve the desired result. Various autologous grafts and alloplastic materials have been described in the literature with their advantages and disadvantages. We report our study on the use of olecranon bone graft for augmentation rhinoplasty in severe saddle nose deformity and discuss our experience with it.
METHODS: In this observational study, 12 patients who underwent dorsal nasal augmentation using olecranon bone graft from August 2011 to December 2020 were studied. All ten patients with congenital deformity underwent graft insertion through a closed rhinoplasty approach, whereas two patients with posttraumatic deformity were operated through old scars over the nasal dorsum. The graft was fixed with screws at nasion in both posttraumatic cases. All the patients were evaluated postoperatively at regular intervals for graft resorption by clinical photographs and X-ray nasal bone.
RESULTS: The age ranged from 20 years to 48 years. No immediate complications related to graft placement were noted. One patient had a hairline fracture of the ulna at the donor site on the 3rd postoperative day which was managed conservatively with a cast. The mean follow-up period was 2 years. No nasal dorsum projection loss or signs of bone resorption were observed for up to 5 years after surgery. One patient with posttraumatic deformity required removal of fixation screw which got exposed after 2 years of surgery.
CONCLUSIONS: Olecranon bone graft is a suitable material for nasal dorsal augmentation in severe saddle nose deformity because of ease of harvest and minimal donor area morbidity. The appropriate thickness of the cortex of the olecranon process allows custom molding and provides resistance to resorption in long term, thereby giving a desirable outcome.

BACKGROUND: The free diced costal cartilage (FDCC) injection technique has been used in the augmentation rhinoplasty for a long time. In order to lower the incidence of nasal contour irregularities and graft displacement, we developed the multiple toothpick-shaped costal cartilage (MTCC) injection technique. This comparative study was conducted to introduce and assess this new technique.
METHODS: This retrospective analysis included 51 patients who underwent augmentation rhinoplasty with either the FDCC or MTCC injection technique at the 17th Department of Plastic Surgery in the Plastic Surgery Hospital between July 2014 and May 2020. The patients were divided into the FDCC (n = 30, 58.82%) and MTCC (n = 21, 41.18%) groups. General data, postoperative patient satisfaction, complications and revision rate were compared between the groups.
RESULTS: Except for the follow-up period, there were no significant differences in general data (age, sex, preoperative dorsum deformity, preoperative rhinoplasty history) between the groups. Postoperative patient satisfaction, complications and revision rate were similar between the two groups.
CONCLUSIONS: The MTCC injection is a safe and effective technique for augmentation rhinoplasty. Like the FDCC injection technique, the new technique is relatively easy to perform and time-saving with concealed scarring and minimal postoperative edema. Most of its revision surgeries are also easy to perform by simple rasping and reinjection. According to our experience, the new technique may have wider indication as well as lower incidence of nasal contour irregularities and graft displacement. Therefore, we suggest that the MTCC injection technique is reliable and worthy of recommendation.
UNASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .