Journal archive · Revision and secondary rhinoplasty · Rib, ear and septal grafts · Nasal tip · Ethnic, Asian, Middle Eastern, African and Latino rhinoplasty · 2026
Versatile Usability of Lateral Crural Strut Graft for Correction of Various Nasal Tip Deformities in Secondary Rhinoplasty in Asians
Kook WS, Kim K, Suh I, Lee JW.
What this paper says
In 37 Asian patients with tip deformities after earlier implant or tip surgery, a lateral crural strut graft raised ROE scores from 30.4 to 75.9 at 12 months or more, working best for lateral crural problems and least for tip deviation.
Overview
Silicone implants and tip work in Asian rhinoplasty can leave notching, pinching, alar retraction, external valve collapse, deviation, over-rotation or malpositioned lateral crura, often worsened by capsular contracture. The Korean authors prospectively followed 37 of 53 secondary rhinoplasty patients (January 2016 to December 2020) who received a lateral crural strut graft (LCSG) and had at least 12 months of follow-up.
Sections of note
- ROE improved from 30.41 to 75.90 (P < 0.001).
- All deformity subgroups improved; "lateral crural deformities" improved most and "tip deviation" least (P < 0.005).
- Complications: 2 asymmetric nostril/tip, 1 visible (bulging) graft, 1 external valve issue (as reported in the abstract).
- Autogenous cartilage was used for all grafts.
- The graft also lengthened contracted noses.
What it means for a patient
- One graft type addressed a wide range of problems left by previous Asian rhinoplasty in this series.
- Improvement was large on a validated satisfaction scale, but a crooked tip was the hardest problem to fix.
- Visible graft edges are a possible trade-off in thin areas.
Why this paper matters
It supports a single versatile technique for the complex revision problems common after implant-based Asian rhinoplasty. Limits: 37 patients, no comparison group, single centre.
Terms
- Lateral crural strut graft (LCSG): a cartilage strip placed under the lateral crus to straighten and strengthen it.
- Capsular contracture: scar tightening around a silicone implant.
- External nasal valve: the nostril opening; collapse means it caves in on breathing.
- Alar retraction: the nostril rim pulled upward, showing too much nostril.
- ROE: Rhinoplasty Outcome Evaluation, scored 0-100.
Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.
Abstract
Background: The insertion of implants and tip plasties have been performed in Asian patients for an attractive and higher nasal profile, which can result in diverse tip deformations such as notching, pinching, alar retraction, incompetent external valve, deviated tip, cephalic rotation, and lateral crus malposition because of inappropriate manipulation of the lower lateral cartilage and/or silicone capsular contracture. This study aimed to investigate the effectiveness and utility of applying a lateral crural strut graft (LCSG) as a consistent and appropriate surgical method to correct various nasal tip deformities that occur as complications following rhinoplasty in Asian patients.
Methods: The authors prospectively studied 37 patients with a minimum follow-up of 12 months among 53 patients who underwent secondary rhinoplasty, including LCSG, between January of 2016 and December of 2020. The results were assessed using the Rhinoplasty Outcome Evaluation scale preoperatively and more than 12 months postoperatively.
Results: Two cases of asymmetric nostril and tip, 1 visible LCSG (bulging) and 1 external SS score, was 30.41 preoperatively and 75.90 postoperatively ( P < 0.001). All subgroups of tip deformities exhibited increased Rhinoplasty Outcome Evaluation scores after the surgery, with the subgroup demonstrating the highest change being "lateral crural deformities," and the lowest change being "tip deviation" ( P < 0.005).
Conclusion: In Asian patients, LCSG using autogenous cartilage would be a useful and versatile option for various types of nasal tip deformities in secondary rhinoplasty, which can effectively improve tip appearance, symmetry, and external valve function, and can also lengthen the contracted nose.
Abstract as indexed by PubMed; the article is open access (PubMed Central).
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Revision and secondary rhinoplasty
181 papers on this topic.
Rib, ear and septal grafts
242 papers on this topic.
Nasal tip
200 papers on this topic.
Ethnic, Asian, Middle Eastern, African and Latino rhinoplasty
167 papers on this topic.
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