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Updated: Jun 12, 2025

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Septorhinoplasty Using Septal L-Strut Extension Graft: A Long-Term Multidimensional Analysis.

Kyung-Chul Moon1, Yu-Kyeong Yun1, Eun-Sang Dhong1

  • 1From the Department of Plastic Surgery, Korea University Guro Hospital.

Plastic and Reconstructive Surgery
|June 10, 2025
PubMed
Summary

Septal L-strut extension grafts (SLEGs) provide stable, long-term nasal dorsal augmentation and tip projection in Asian rhinoplasty. This technique effectively advances the lower nasal dorsum, reducing reliance on heavy alloplastic implants.

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Area of Science:

  • Plastic Surgery
  • Rhinoplasty Techniques
  • Facial Reconstruction

Background:

  • Traditional Asian rhinoplasty often uses alloplastic implants for dorsal augmentation and septal cartilage for tip projection.
  • Excessive submucosal resection can compromise septal support, leading to complications with heavy dorsal implants.
  • Utilizing cartilage grafts for anterior projection can minimize the need for dorsal onlay grafting.

Purpose of the Study:

  • To evaluate the long-term stability of septal L-strut extension grafts (SLEGs).
  • To assess SLEG efficacy in advancing the lower two-thirds of the cartilaginous nasal dorsum and achieving tip projection.

Main Methods:

  • A retrospective analysis of 407 patients undergoing septorhinoplasty with SLEGs (August 2012-December 2022).
  • Outcomes assessed via patient satisfaction, nasal tip hardness, functional obstruction, and pain scores.
  • Anthropometric analysis using 2D and 3D photographs, with comparisons to control groups using alternative grafting techniques.

Main Results:

  • SLEGs demonstrated sustained advancement of the lower nasal dorsum and long-term tip projection.
  • Control groups showed initial tip projection that diminished over time compared to the SLEG group.

Conclusions:

  • Septal L-strut extension grafts (SLEGs) are effective for achieving stable, long-term advancement of the lower nasal dorsum.
  • SLEGs offer a reliable method for tip projection dependent on septal support.