[Dr. Koh Seung-jo's Lecture Notes] Septal Extension Graft Part 1

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Hello.

💖your beauty universe! This is Dr. Seo Seung-jo from Wevers Plastic Surgery :)💖

Today, we will explore septal extension graft and columellar support.

Q: What is the difference between septal extension graft and columellar support?

To raise the nasal tip, there are two methods:

septal extension graft and columellar support.

When looking at the nose from the side,

the bone inside the nose is called the septum.

During rhinoplasty, a portion of this septum is harvested.

Cutting the harvested septum and connecting it to the existing septum in front of it

is called a septal extension graft.

Q: Is septal extension graft correct or not?

Let's look at an example.

If the length of the septum is extended slightly upwards, not downwards,

this can also be considered a septal extension graft.

Similarly, extending the septum in a forward direction

can also be called a septal extension graft.

Q: What is the crucial core of septal extension graft?

Extension means connecting the harvested septum to the original septum.

What happens when septa are connected to each other?

The length is extended.

The septum is extended by adding more septal cartilage.

Ultimately, the crucial core of septal extension graft is that

if the septum and cartilage are connected,

that is septal extension (septal extension graft).

Many people usually think that extension only refers to lengthening the nose downwards,

but in reality, that is not the case.

Q. What is the direction of connection in septal extension graft?

As explained above, septal extension graft ultimately means

connecting the septum and cartilage.

When the septum and cartilage are connected and fixed,

the nasal tip is fixed. When it's fixed,

it can be extended forward or lengthened downwards.

It can even be lengthened upwards,

which applies to cases of a short nose.

Conversely, for a long nose, the support is built slightly upwards.

Ultimately, regardless of the direction,

if the septum and harvested cartilage are connected,

it can all be considered a septal extension graft.

Q. What is the important connection point for septal extension graft?

When using facial muscles, due to muscle movement,

the nose can retract inwards when smiling,

and a downward pulling force is generated.

This causes pressure on the nasal tip, leading to the tip drooping.

Also, if the direction of septal connection is only downwards,

the nasal tip is bound to droop.

When performing a septal extension graft,

there must be a direction that determines the position of the length,

but the extension must also be done in a way that provides strong support.

As shown in the purple-marked section,

if the septum is extended in different directions simultaneously,

there is an upward supporting force from below,

which acts as a combined support.

Even if the septum is connected as a whole,

it still acts as a support.

Sometimes people think that if columellar extension is done incorrectly, the nasal tip will become crooked and drop.

To prevent the nasal tip from becoming crooked and dropping,

the columellar support must be properly constructed.

When performing a septal extension, the septum and cartilage are gradually connected,

acting as a support.

This is also a septal extension graft or support.

When only a septal extension graft is performed and the support force is only in the direction of extension,

there is a tendency for it to droop slightly.

Therefore, especially for short or long noses,

the force of support in the direction of the septum pushing from below to above,

whether connected or not, by the bone slightly in front, is necessary.

If the connection of the septal extension graft is not done well,

the nose might wobble up and down,

or side to side.

That's why support force in the right direction is needed,

to prevent the problem of the nasal tip dropping.

In the next Part 2, we will discuss columellar support.

https://www.youtube.com/watch?v=_nO-loQsocE

💖If you have any further questions?

Frequently Asked Questions

What is septal extension graft surgery?

Septal extension graft surgery is a procedure that connects septal cartilage harvested during nose surgery to the existing septum to raise or extend the nasal tip. It refers to all methods where the septum and cartilage are connected and fixed, and it is applied in various directions depending on the shape of the nose.

Does septal extension graft surgery only make the nose longer downwards?

No, septal extension graft surgery can extend the nose not only downwards but also forwards or upwards. For example, in the case of a short nose, it is extended upwards, and in the case of a long nose, a support is built in an upward direction to correct it.

Why does the nasal tip droop when I smile after nose surgery?

It is due to the movement of facial muscles. When you smile or make expressions, the muscles exert a downward pulling force on the nasal tip, and if the support's strength is insufficient or the extension direction is only downwards, the nasal tip will droop under pressure.

How can I prevent nasal tip drooping and deviation?

When performing septal extension, a strong supporting structure that props the nose up from below must be created. When determining the extension position, it is important to extend in multiple directions or connect it as a whole to ensure the support can withstand the force, thereby fixing the nasal tip so it doesn't wobble.