Tunneled Paranasal Augmentation Using Diced Autologous Costal Cartilage in Asian Rhinoplasty: A Comparative Study

Overview

Underdevelopment of the front upper jaw is common in Asian populations, producing hollowing beside the nose that often accompanies a low bridge. The authors state its effect on facial harmony is underestimated. They retrospectively compared patients treated between June 2017 and June 2021, grouped by whether the paranasal hollow was augmented alongside the rhinoplasty.

Sections of note

• Design: retrospective comparative study, 56 patients. Level of evidence IV. Groups: control without paranasal augmentation, observation group with it.
• Objective measures from sagittal planimetry: columella base prominence and alar base prominence.
• Subjective measures: FACE-Q rhinoplasty and facial modules, plus physician rating on the Global Aesthetic Improvement Scale.
• Both groups improved significantly in columella and alar base prominence, p less than 0.01.
• The augmented group was superior on alar base prominence, 2.5 degrees, p less than 0.01, FACE-Q facial scores, 7.49 points, p less than 0.05, and Global Aesthetic Improvement Scale, p less than 0.05.
• No difference was found in columella base prominence or FACE-Q rhinoplasty scores.
• Complications: nostril base asymmetry 6.9 percent, foreign body sensation in the face or mouth 34.5 percent.

What it means for a patient

• Filling the hollow beside the nose improved satisfaction with the whole face, but not satisfaction with the nose itself.
• More than a third of augmented patients reported a persistent sensation of something present in the face or mouth.
• The nose alone can be raised without addressing the hollow, and both groups improved, but the added step targeted a different area.
• Limits: 56 patients, retrospective, groups not randomized, and complication percentages appear to be calculated on the augmented subgroup rather than the whole sample.

Why this paper matters

Rhinoplasty in populations with a retruded midface addresses only part of the profile, and the flat area beside the nose is routinely left alone. Measuring whether filling it improves facial satisfaction tests that omission. The high rate of foreign body sensation is a real cost that the abstract does not weigh against the benefit.

Terms

• Paranasal concavity: hollowing of the face immediately beside the nose.
• Maxilla dysplasia: underdevelopment of the upper jaw bone.
• Diced cartilage: cartilage cut into tiny pieces so it can be molded like a paste.
• Alar base prominence: how far forward the foot of the nostril sits.
• FACE-Q: a validated questionnaire measuring satisfaction with facial appearance.