The External Strip and Internal Spreader Graft Combined with Dorsal Preservation Rhinoplasty.

[BACKGROUND] Rhinoplasty, particularly for the correction of dorsal hump deformities, has become increasingly common. Traditional methods, including hump resection, are frequently performed, and dorsal preservation techniques are gaining popularity. Septal deviation deformity is a common issue in rhinoplasty patients, significantly affecting both appearance and nasal function. Spreader grafts and flaps are essential components of traditional rhinoplasty to correct open-roof deformities, deviations, or dorsal aesthetic lines. This study combined internal spreader and external strip grafts with dorsal preservation rhinoplasty to enhance outcomes.

[METHODS] A retrospective analysis was conducted, assessing 152 patients who underwent dorsal preservation rhinoplasty for nasal hump deformity, with or without septal deviation, between July 1, 2019, and September 1, 2022. External strip and internal spreader grafts were used in 52 of 152 patients. Inclusion criteria were nasal hump deformity, cephalocaudal C-shaped septal deviation, no deviation, and a concavity at the upper lateral cartilage (ULC) and W-ASA segment (the area between the W-point and anterior septal angle). Patients were evaluated using the Rhinoplasty Outcome Evaluation questionnaire before and 12 months after surgery.

[RESULTS] The median patient age was 24.9 years. The postoperative follow-up period ranged from 16 to 26 months. Rhinoplasty Outcome Evaluation scores improved significantly, from a median score of 56.5 preoperatively to 92.5 postoperatively ( P < 0.001). Patient satisfaction was excellent in 90% of cases. External strip and internal spreader grafts effectively addressed the deviation, ULC concavity, and W-ASA segment collapse without disrupting dorsum integrity.

[CONCLUSIONS] Combining external strip and internal spreader grafts with dorsal preservation rhinoplasty techniques provides effective solutions for correcting dorsal hump and septal deviation deformities, improving ULC concavity, preventing W-ASA segment collapse, and preventing and improving nasal valve collapse. This approach yields superior cosmetic and functional outcomes, offering an advanced method for rhinoplasty surgeons.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Therapeutic, IV.