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

#Septum #SeptalExtensionGraft #Columella #ColumellaCorrection #ColumellarStrut #NasolabialAngle #Rhinoplasty #NoseSurgery #NoseTip #NoseTipCartilage #Uber #SeoSeungJo #ShimJungHwan #ParkSunHee #Nose

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Hello.

💖your beauty universe! I am Dr. Seo Seung-jo, head director of Uber Plastic Surgery :)💖

Today, we will learn about the septal extension graft

and the columellar strut.

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

To raise the nose tip,

we use either a septal extension graft or a columellar strut.

When looking at the nose from the side,

the bone inside the nose

is called the septum.

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During rhinoplasty, a portion of

this septum is harvested.

Cutting the harvested septum

and connecting it to the front of the existing septum

is called a septal extension graft.

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Q: Is this a septal extension graft or not?

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Let's look at an example.

If the length of the septum is extended slightly upwards

rather than downwards,

this can also be considered a septal extension graft.

Similarly, extending the septum forwards

can also be called a septal extension graft.

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Q: What is the key point of a septal extension graft?

Extending means connecting the harvested septum

to the original septum.

What happens when you connect the septal cartilages together?

The length is extended.

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It is extended by adding septum to the septum,

so the important core of the septal extension graft is

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that if the septum and cartilage are connected,

you can consider it a septal extension (septal extension graft).

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Usually, many people think the length must increase,

so they consider only the downward extension of the nose

as an extension graft,

but in reality, that is not the case.

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

I explained above that

you can simply think of a septal extension graft

as connecting the septum and cartilage.

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When the septum and cartilage are connected and fixed,

the nose tip is secured. When it is fixed,

it can be directed forwards or lengthened downwards.

It can even be lengthened upwards,

which applies in the case of a short nose.

Conversely, for a long nose, the strut

is erected in a slightly upward direction.

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Ultimately, regardless of the direction,

if the septum and the harvested cartilage are connected,

it can all be considered a septal extension graft.

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Q. What is the important point of connection in a septal extension graft?

When using facial muscles, due to the muscles,

smiling pulls things inward

and generates a downward drooping force.

When this happens, the nose tip receives pressure, causing

the nose tip to droop downwards.

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Also, if you think the direction of the septal connection

is only pointing downwards,

the nose tip is bound to droop.

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When performing a septal extension graft,

there must be a direction that determines the length's position,

but the extension must be done in a way

that firmly receives the supportive force of the strut.

As shown in the purple highlighted area,

if the septum is extended together in different directions,

there is an upward supporting force from below,

so it also acts as a strut.

Even if the septum is connected as a whole piece,

it still performs the role of a strut.

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There are cases where people think that if a columellar extension is done incorrectly, the nose tip will deviate

and droop.

To prevent the nose tip from deviating and drooping,

the columellar strut must be erected properly.

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

acting as a strut.

This is also a septal extension graft or a strut.

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When only a septal extension graft is performed and

the strut's force is received only in the direction of the extension,

there is a tendency for it to droop slightly.

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Especially in short or long noses,

whether connected or not to the septum pushing from bottom to top,

a supportive force in the direction of the strut

is necessary, provided by the bone slightly further in front.

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If the connection of the septal extension graft

is not done well,

the nose could easily wobble up and down,

or it could wobble from side to side.

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Therefore, the force in the direction of the strut is needed,

which prevents the problem of the nose tip drooping.

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In the next Part 2, we will learn about

the columellar strut.

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

💖If you have any further questions?

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