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The Princess and the Pea Graft-A Solid Cartilaginous Tip Graft for Noses with Thick Skin Envelope
Chew Lip Ng1, Sean B J Loh2, Nevin Y M Chua3
1Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore.
Introduction:
Thick skin-soft tissue envelope (SSTE) and weak cartilage make nasal tip definition challenging in many Asian rhinoplasty patients.
Objectives & Hypotheses:
We aimed to assess whether the Princess and the Pea (PP) graft-a solid, conical costal cartilage tip graft-can improve tip projection and definition in thick-SSTE patients. We hypothesized that it would yield reliable aesthetic and functional results with minimal complications.
Study Design:
Prospective clinical study with 12-month postoperative follow-up.
Methods:
Sixty patients of East, South, and Southeast Asian descent received a PP graft anchored to the lower lateral cartilages. Outcomes were measured using SCHNOS and a 5-point Likert satisfaction scale.
Results:
Mean satisfaction was 4.5/5, average SCHNOS score 0.54, and no graft-related complications occurred.
Conclusion:
The PP graft is a safe and effective method for enhancing nasal tip projection and definition in thick-SSTE patients.
