Introduction: Nasal defects and deformities caused by various congenital, iatrogenic, pathological, and traumatic factors result in aesthetic and functional deficiencies, leading to significant psychological distress for patients. Additionally, the majority of Asians have a low and wide nasal bridge, enlarged nasal tip, thick skin, abundant subcutaneous tissue, and weak nasal cartilage support. These factors present challenges for nasal plastic surgery in Asians. In addition to requiring surgeons to master the overall nasal anatomy and anatomical details, nasal plastic surgery also demands consideration of facial proportions and balance in aesthetics.
As a professional rhinoplasty institution and rhinoplasty surgeon, Dr. Wu Wenyun, the director of the Beijing Miyanglige Medical Cosmetology Hospital, stated: "In Asians, the septal and lower lateral cartilages of the nose often have insufficient development, and the skin is tight with thick soft tissue. It is difficult to achieve satisfactory results solely through surgery using implants and cartilage sutures. Therefore, it is necessary to strengthen the nasal tip support with thicker and harder grafts and reconstruct the septal structure to achieve more satisfactory surgical results. However, excessively thick grafts can result in a stiff nasal tip, reduced mobility, and even increased airway resistance due to excessive occupancy within the nasal cavity, affecting ventilation." Therefore, Dr. Wu Wenyun's team at the Beijing Miyanglige Rhinoplasty Center proposed and summarized the use of thinner and more resilient cortical rib cartilage instead of traditional medullary rib cartilage as a method to improve nasal tip shape and modify grafts, publishing their findings in the national professional academic journal, the "Chinese Journal of Medical Aesthetics and Cosmetology," under the title "The Effect of Autologous Rib Cartilage on Improving Nasal Tip Shape".
From the research subject to surgical techniques and postoperative outcomes, a comprehensive analysis, theoretical exploration, and practical application will be conducted. Utilizing typical cases as demonstrations, this will thoroughly illustrate the significant advantages of using rib cartilage to shape the nasal tip:
In rib cartilage harvesting, CT scans are utilized to assist in obtaining relatively straight rib cartilage for slicing.
In the preparation of rib cartilage, the most challenging aspect is combating the curling caused by the inherent stress of the rib cartilage itself. Under the leadership of Director Wu, the team at Miyang Lige Rhinoplasty integrates the oblique cutting method and central carving method, removing a 0.6mm thickness of rib cartilage cortex. They employ an opposing suture method to counteract bending by altering the internal tension.
The rib cartilage grafts obtained through this method exhibit straight, thin, and flexible characteristics, aiming to reduce nasal cavity occupation without affecting ventilation and breathing.
For cases of slight deviation in the nasal septum, the two pieces of rib cartilage cortex at the tail end are utilized to achieve a centrally positioned appearance. This method avoids disturbance to the septal cartilage, enhancing stability while better shaping the nasal septum extension.
The remaining rib cartilage cortex is sculpted into shield or cap-shaped grafts according to nasal aesthetics and polygonal aesthetic principles, achieving a prominent nasal tip and fullness under the nasal tip lobule, thus attaining a full nasal tip morphology.
To prevent nasal tip pinching, cap-shaped grafts can also be utilized to enhance tip projection while ensuring natural transitions between the sides of the nasal tip and alar-columellar junction.
Regarding nasal tip mobility, the use of thin, elastic, and resilient rib cartilage cortex provides greater nasal tip mobility and a relatively soft touch.
For long-term effects, to avoid nasal tip visibility, rib cartilage membrane is grafted onto the cartilage surface, increasing tissue thickness and enhancing adhesion between the graft and surrounding tissues, ensuring a more robust long-term result and integration with the native tissue.
As a professional rhinoplasty institution, Beijing Miyang Lige keeps pace with the trends in rhinoplasty and the evolving standards of beauty, striving to meet the needs of more individuals seeking aesthetic enhancements, from both technical and aesthetic perspectives.
