Short nose correction

Man Koon Suh, M.D.

JW Plastic Surgery Center, Seoul, Korea

I. Introduction

Short nose means too much nostril show as well as short length of nose. So the

correction must aim at not just lengthening of the nose but also reducing too

much visible nostril floor.

Short nose correction is one of the most prestigious and high-level techniques in

Asian rhinoplasty.

This presentation will cover both simple primary short nose and severe

contracted short nose due to infection or multiple operations.

II. Methods

1. Primary short nose correction

For the primary short nose correction, the surgeon must be familiar with such

techniques as alar cartilage release from upper lateral cartilage(ULC) and

maintaining techniques of released alar cartilage(septal extension graft, derotation

graft, L-shaped strut).

<Derotation graft> <Septal extension graft, by Byrd>

<L-shaped strut, by MK Suh>

In case harvested septal cartilage is too small and insufficient to do the septal

extension graft effectively, hybrid septal extension graft designed by the author

can be a good option to overcome small septal cartilage. IHCC(irradiated

homologous septal cartilage) is carved into thin batten shape and fixed to the

caudal septum bilaterally and the small septal cartilage is fixed between two

IHCCs.

<Hybrid septal extension graft>

2. Contracted short nose correction

Mid- or high level surgeons are challenged by severe contracted short nose.

Contracted nose correction requires scar tissue release, alar cartilage release, dual

plane dissection of the skin envelope from the underlying scar tissue(capsule) and

septal extension graft using septal cartilage or rib cartilage.

<Dual plane dissection in the contracted short nose correction>

3. Cases

(1) Case I: Contracted short nose correction using septal extensioin graft

with septal cartilage

(2) Case II: Contracted short nose correction using septal extension graft with

IHCC

(3) Case 4: Collapsed midvault reconstruction and contracted short nose

correction using rib cartilage