X-shaped Tip Graft: A Versatile Solution for Warping Correction in Rib Cartilage-Based Rhinoplasty.

Area of Science:

• Plastic Surgery
• Facial Reconstruction
• Nasal Aesthetics

Background:

• Achieving stable tip grafts is crucial for successful rhinoplasty outcomes.
• Rib cartilage grafts are prone to warping, leading to unpredictable long-term results in cartilage-based rhinoplasty.

Purpose of the Study:

• To detail and validate a novel X graft technique for rhinoplasty.
• To assess the stability and effectiveness of the X graft in preventing warping and enhancing nasal tip support.

Main Methods:

• Retrospective analysis of counterrotating force and complications in 45 female patients.
• Three-dimensional stereophotogrammetric evaluation and blinded anthropometric analysis.
• Assessment of tip projection, nasal length, tip rotation, and nasion-pronasale angulation.

Main Results:

• The X graft demonstrated excellent long-term maintenance of tip position with insignificant changes in nasion-pronasale angulation.
• Significant improvements were observed in tip projection, nasal length, and nasolabial angle.
• No statistically significant differences were found between short- and long-term follow-up results.

Conclusions:

• The X graft effectively mitigates graft warping, providing superior tip support and nasal elongation.
• This technique offers versatility and flexibility, creating strong, sustainable tip support, particularly for East Asian rhinoplasty.
• The X graft represents an ultimate form for nasal tip support and correction of short noses.