Flexible Nasal Tip Produced by Slender Septal Extension Graft

Septal extension grafts (SEGs) can increase projection. However, it requires a large amount of graft and can result in a frozen tip. Thus, this study introduces a modified SEG, called a partial SEG. Partial SEGs minimize the amount of graft material requirement, avoid the occurrence of frozen tips, and increase nasal tip projection. This method is comparable to the fixed-mobile SEG (Rohrich et al. in Plast Reconstr Surg 149: 1350-1356, 2022) and anterior nasal septal angle (ANSA) banner (Neves and Tagle in Ann Plast Reconstr Surg 4(3): 1059, 2020); however, unlike those techniques, the tip is not sutured to the graft and the alar complex is not fixed, allowing free movement of the nasal tip within its anatomical limits. To further prevent long-term displacement or minimize loss of nasal tip projection, a method of fixing the graft with Prolene and a third end-to-end SEG method for preventing sliding between grafts were used, which was also effective. Among the patients who underwent surgery between September 2019 and September 2023, 238 were followed up for over 6 months. Most patients were satisfied with the natural and flexible nature of the nasal tip. In conclusion, the alar wrap around a slender SEG technique can be an option for who want a flexible nasal tip that is projected adequately rather than excessively.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .