Lengthening the short nose.

Abstract

In the more difficult cases of short nose deformity in which there is loss of septal membrane, lining as well as cartilage must be provided to adequately correct the functional and aesthetic deformity. A discussion of these techniques is outlined and a procedure discussed that makes use of staggered septal incisions to aid in implanting the composite conchal graft. After release of the entire inferior septal columella unit, a gap remains, which is filled by a composite conchal graft. The mechanics of the steplike incisions enable the bare-grafted cartilage, which has been denuded of conchal perichondrium, to be covered by normal septal perichondrium. The risk of perforation or graft failure is greatly reduced due to the rich blood supply of the septal mucosa, which provides nutrition to the cartilaginous surfaces. The benefits, complications, and limitations of the procedure are described.