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Spreader and L Shape Dorsal Cartilage Augmentation in Saddle Asian Nose

INTRODUCTION
Septorhinoplasty is a complex facial plastic surgery, which requires preservation of the integrity of anatomic structures of the entire nose in order to improve functional , aesthetic and
results. This is especially critical in patients with saddle nose deformity, characterized by under projected cartilaginous dorsum, and under projected and over-rotation of the nasal tip in Asian
nose. Various classification systems were described for saddle nose deformities.2 According to Tardy et al, it can be classified as mild, moderate, and severe. 3 Mild deformities are
characterized by low supratip without loss of the structural integrity. Moderate deformities include a loss of quadrangular cartilage, reduced dorsal height, and retracted columella. Major
deformities of the tip, dorsum, columella, and nasal valves are seen in severe deformities. Nasal dorsal augmentation is a significant part of reconstructive surgery of the saddle nose
deformity. Augmentation of the dorsum is performed for aesthetic outcomes and structural integrity.
A suitable graft material is needed for the integrity especially in severe deformities. Various materials like autologous graft septal, auricular/conchal and costal cartilage. An autograft is
usually preferable owing to low rates of infection and extrusion despite the possibility of donor site morbidity. A costal cartilage graft possesses the advantage of low rate of absorption, and it can be obtained in large amounts. In addition to that graft takes the advantages of being easy to harvest after being enshaped.6,7 In addition to various techniques described as nasal dorsal grafts with costal
cartilage,4 in this article, we described a novel technique for the same purpose in patients with moderate and severe saddle nose deformities.