Abstract
Aims and Background
Reduction structured rhinoplasty is a rhinoplasty technique that combines elements
from two rhinoplasty philosophies: simple reductive rhinoplasty and structural rhinoplasty.
The goal is to achieve decreased nasal size while supporting a life-long, lasting
nasal shape by employing the use of structural grafts.
Historical Aspects
Reducing nasal size without replacing disrupted nasal support structures has historically
led to poor outcomes.
Techniques
Structural grafts include spreader grafts, onlay tip grafts, columellar strut grafts,
caudal septal extension grafts, and more. They are utilized to prevent internal nasal
valve collapse, provide tip support, and prevent tip ptosis, retraction, or poor healing
outcomes due to scarring. Different materials, including autologous cartilage and
allogenic implants (i.e., high-density porous polyethylene) can be used as graft material.
Preference for specific graft use differs from surgeon to surgeon, and continuous
debate exists surrounding which grafts provide the most optimal results.
Conclusion and Clinical Relevance
This study outlines Romo III's tenured approach to reduction structured rhinoplasty
and discusses various trends and debates in grafts that are currently utilized.
Keywords reduction structured rhinoplasty - structural rhinoplasty - nasal tip graft - onlay
tip graft - columellar strut graft
