Lengthening the congenitally short nose

A 20-year-old man with a congenitally short nose underwent a corrective two-stage technique. The technique consists of wide undermining of supranasal and paranasal skin, use of composite auricular grafts from the ear to lengthen the upper lateral cartilages, use of a chondromucosal septal flap for lengthening the septum, and postoperative downward taping to assure adequate stretching of dorsal skin for the first-stage procedure. A second stage to reaugment the dorsum using septal cartilage and vomer was performed one year later, and the results 15 months after the second stage show persistent successful lengthening, including downward rotation, less obtuse nasolabial angle, and elimination of the pug nose stigma.