For Asian individuals, an ideal nose typically has a length from the nasal root to the tip that accounts for approximately one-third of the entire face, with a nasolabial angle between 95° and 105°. If the length is insufficient or the nasolabial angle exceeds 105°, the nose may appear short and upturned.A short upturned nose may be congenital or result from excessive nasal tip retraction following silicone implant rhinoplasty. Such cases require short nose lengthening surgery to achieve aesthetic refinement.The debate over autologous cartilage materials in aesthetic surgery is particularly intense, focusing on three key points: Is auricular cartilage superior to septal cartilage in simple extension procedures? Can septal cartilage adequately meet the demands of extension surgery? And the application of costal cartilage in nasal extension procedures.
I. Is Auricular Cartilage Superior to Septal Cartilage?
Many mistakenly believe auricular cartilage outperforms septal cartilage in extension procedures. While harvesting auricular cartilage is simpler than septal cartilage, auricular cartilage resembles ordinary paper, whereas septal cartilage is like a sturdy index card.While ear cartilage is more abundant than septal cartilage, it lacks sufficient inherent support. When subjected to external pressure, it easily bends and deforms. Consequently, surgeons often need to layer multiple sheets of ear cartilage to achieve the required structural support. In contrast, septal cartilage offers excellent elasticity and strength; a single piece can fully meet the support demands of nasal augmentation.
II. Is Septal Cartilage Insufficient for Surgery?
Some practitioners believe Asians have less septal cartilage than Westerners, raising concerns about its adequacy for nasal extension. In reality, due to the septum's inherent supportive properties, harvesting a 2.5cm-long, 1.5cm-wide segment from the caudal septum for expansion grafting achieves excellent extension results.Nearly 90% of Asian individuals possess sufficient septal cartilage volume to meet surgical material requirements, eliminating concerns about compromising the nose's inherent support structure.
III. Septal Cartilage is Optimal for Isolated Nasal Extension Surgery.
Many rhinoplasty procedures combine nasal augmentation with lengthening. In such cases, rib cartilage is optimal. Its substantial volume and thickness allow simultaneous elevation and lengthening of the nasal bridge. If performing only one procedure, nasal lengthening should be done first for optimal results. For pure nasal lengthening, septal cartilage is the best choice.