Different techniques for caudal extension graft placement in rhinoplasty.

[INTRODUCTION] The caudal extension graft is usually a cartilage graft that overlaps the caudal margin of the nasal septum. A combination of the caudal extension graft and the tongue-in-groove technique is used to stabilize the nasal base, set tip projection, and refine the alar-columellar relationship.

[OBJECTIVES] In this study we present some new modifications to the placement of caudal extension grafts in rhinoplasty.

[METHODS] This study is a retrospective review of a prospectively collected database of 965 patients who underwent septorhinoplasty from June 2011 to July 2015. Of these, 457 patients required a caudal extension graft and were included in the study. Minimum follow-up was 13.2 months with a mean follow-up time of 17.4 months.

[RESULTS] In most cases, comparison of photographs before and after surgery were satisfactory and showed improved contour. Minor deformity was detected in 41 patients and 11 patients needed revision surgery.

[CONCLUSION] With these modifications the surgeon can employ the caudal extension graft even in angulated caudal septal deviations. A variety of methods have been proposed for correction of caudal nasal deviation.