A new technique to strengthen the nasal septum in rhinoplasty using a titanium microplate

Abstract

Background: Most short Asian noses have a small, thin, weak and deviated nasal septum. Therefore, it is very challenging to predict the precise strength and length of the nasal septum and prevent tip deviation, instability, and drooping. In particular, the remaining nasal septum shows fragility and instability in case of revision rhinoplasty. Thus, costal cartilage was popularly used for revision cases. However, it was difficult to fix and secure the new columella graft when extending the septum. Objective: This study was performed to strengthen the nasal septum using a combination of costal cartilage and a titanium microplate to achieve a good nasal tip platy result in revision rhinoplasty cases. Methods: The 25 patients who underwent the revision who underwent were treated with a titanium microplate and autologous costal cartilage rhinoplasty. The titanium microplates were used and fixed by titanium screw at the basement of the nasal floor, and then secure the costal columella strut to the titanium miniplate to prevent the expected complication of costal columella struts, such as warping, deviation, instability, and drooping. They were followed up 1 month to 10 months. Results: The patient’s satisfaction was very high. One case of infection in which the patient had a history of previous non-biological filler injections and 2 cases of nasal deviation from the weak and soft costal cartilage from a young age were observed. Conclusion: The use of titanium miniplate with costal cartilage for rhinoplasty, especially nasal tip surgery is safe, effective, stable, and reliable. This solution will also benefit primary and secondary rhinoplasty for a compromised nasal septum.

Keywords

• costal cartilage; nasal septum; reoperation; rhinoplasty; titanium