[Nose Seung-jo's Lecture Notes] Septal Extension Graft Part 2

#Septum #SeptalExtensionGraft #Columella #ColumellaCorrection #ColumellarStrut #NasolabialAngle #Rhinoplasty #NoseSurgery #NoseTip #AutologousCartilage #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 :)💖

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Today, we will learn about one of the methods to beautifully elevate the nose tip,

which is the columellar strut graft.

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The necessity of a septal extension graft and a columellar strut?

When performing rhinoplasty, if only a columellar strut is used,

it can easily wobble up and down,

or it can also sway from side to side.

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Because of this,

we connect it using a septal extension graft.

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In other words, when it is in an unstable state,

adding a septal extension graft

helps it become much more stabilized.

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This is the side profile of the nose.

The part marked in mint color is

the alar cartilage.

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Originally, the alar cartilage and the septal cartilage

function separately from each other.

Meaning, they move independently.

In this case, when we say 'we build a strut,'

you would generally assume

that it is erected in this direction.

If the strut is erected in the direction shown in the picture,

when force is applied to the outside of the nose or where the columella is located, like the direction of the arrow,

it can withstand the pressure well.

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But what is the problem?

If there is only a columellar strut,

assuming it is not connected to the septum,

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it can easily wobble up and down,

and it can easily sway from side to side.

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If a columellar strut is used alone here,

the characteristic is that the nose tip feels soft,

but conversely, you must consider that it can be unstable.

That is why, together with a septal extension graft,

we extend it.

When connected to the septum,

the forces moving side to side and up and down

are stabilized,

so this instability can be resolved.

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In other words, when a septal extension graft is applied,

you can consider it to be much more stabilized.

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Q: How is the columellar strut fixed?

The columellar strut can also be

firmly fixed to the bone,

which is called a 'fixed' type.

It can also be left unattached, which is called a 'floating' type.

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In the case of the fixed type,

because it firmly erects the septum,

when you press the nose tip, it may move up and down and side to side, but

when pressed, it is firmly anchored so it does not get pushed in.

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However, what about the floating method where it is left unattached?

Because this much is not fixed,

this much can go inside and move around.

You can see that there are differences in pros and cons.

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In conclusion,

in most cases, to significantly elevate the nose tip,

a columellar strut alone is slightly insufficient to raise it fully,

so you can consider that the septal extension graft method is widely used.

The reason why the septal extension graft method is widely used

is because of this.

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Q: What if only a septal extension graft is performed, but a large amount of septum cannot be harvested?

When the extension graft is used alone,

the direction receiving the supporting force must not be weak.

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The septal extension graft must act as a strut

and be connected in a direction that allows it to function properly

so that the nose can withstand the pressure well.

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However, if only a septal extension graft is being performed,

and a large piece of cartilage cannot be harvested,

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what is needed is

a cartilage graft in the form of a columellar strut.

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Only by doing this can the nose tip be made higher

and more projected,

and the most optimal nasolabial angle

can be definitively corrected.

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Of course, with just a columellar strut,

the nose tip can be elevated.

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The biggest advantage is that it is 'soft,'

but because it can be slightly unstable,

you should consider that it cannot be raised significantly.

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This concludes our discussion on the columellar strut and septal extension graft,

which we have explained in detail.

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Next time, we will return with more detailed

and new content.

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https://www.youtube.com/watch?v=QPs808dDvao

💖If you have any more questions?

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