Secondary Asian rhinoplasty: lengthening the short nose

Kim SK, Kim HS.

PubMed 23395883 Publisher (DOI)

What this paper says

In 38 Asian patients with short noses, 33 of them after earlier surgery, a rib cartilage septal extension graft lengthened the nose by an average 8 mm with all patients satisfied at a mean 2.5 years, one collapsed lung and no infection or exposure.

Overview

A nose can be too short by nature, after a previous rhinoplasty or after injury. Lengthening requires a strong extension of the septum, and in revision cases the septal cartilage is often already gone. The authors use rib cartilage for the extension graft and report their experience.

Sections of note

38 consecutive Asian patients, January 2005 to February 2010; 5 primary and 33 secondary short nose deformities; 7 men, 31 women; mean age 28.5.
Indications listed: damaged septal cartilage, innate septal problems, saddle nose, skin problems, and cleft lip nose deformities.
Single rib cartilage septal extension graft in 32; double graft in 6.
Where the septum had been overresected, additional supporting rib grafts reinforced it.
Mean follow-up 2.5 years.
Average lengthening from root to tip: 8 mm.
All patients satisfied with the lengthened shape.
1 pneumothorax; no cartilage exposure or infection.

What it means for a patient

A short nose left by a previous operation can be lengthened with rib cartilage when the septum has nothing left to give.
The change is substantial, close to a centimeter on average.
Rib harvest carries a small risk of lung puncture, seen once here; satisfaction was reported without a validated scale and there was no comparison group.

Why this paper matters

The short nose is the signature revision problem in Asian rhinoplasty, often after silicone implant contracture. This series shows rib septal extension as a durable fix over 2.5 years. Warping, a known rib risk, is not mentioned in the abstract.

Terms

Short nose deformity: a nose too short from root to tip, often with an upturned tip.
Septal extension graft: cartilage fixed to the front edge of the septum to push the tip forward or downward.
Rib cartilage graft: cartilage harvested from the patient's own rib.
Saddle nose: a sunken bridge from loss of septal support.
Pneumothorax: air leaking into the chest cavity, collapsing part of the lung.
Secondary rhinoplasty: a repeat operation on a nose that has already had surgery.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Short nose deformity results from primary short nose, previous rhinoplasty, or trauma. A septal extension graft using rib cartilage can be placed to address this deformity. Indications for this procedure include previously damaged septal cartilage, innate septal issues, saddle nose deformity, skin problems, and…”

Excerpt; the full abstract is on PubMed.