I don't want to do a nasal septum extension."
'Lengthen the tip of your nose with nasal septum extension to give you a twangy nose.'

In many cases, patients come for a consultation after deciding in advance whether or not to have a nasal septum extension.

For some patients, nasal septum extension is

Surgery to lengthen the tip of the nose
Surgery for a sharp point
Surgery to be bent after surgery
Major surgery

This seems to be the image of the company.

These images seem correct and capture only some aspects.

What is a nasal septum?

The nasal septum is located in the middle of the nose and serves to divide the nasal cavity into right and left sides while supporting the nasal strips.

The nasal septum is composed of cartilage, bone, and membrane tissue, and it is primarily the cartilaginous portion that is manipulated in nasal septum extension.

Nasal septal extension is an operation in which the harvested nasal septum cartilage, auricular cartilage, or rib cartilage is added to the nasal septum cartilage.

As I mentioned in my last column, the skin of the nose will have a force that tries to return to its original state for about 6 months after surgery. The skin itself tries to shorten and lower itself. Therefore, the key to a successful surgery is to create a frame that can withstand this force in the long term. A frame that is as tight as possible with minimal movement is necessary to change and maintain the shape of the tip of the nose.

The problem here is that the tip of the nose is something that has a certain degree of movement.

Since the nose is located in the center of the face and is easily subjected to external forces such as touch and bumps, a soft and movable nose is more advantageous in passing external forces than a hard and stiff one. The tip of the nose also moves with facial expressions, such as smiling, because it has a certain degree of softness.

If you gently insert your fingers through the nostrils on either side, you will touch a little hard plate-like cartilage in the midline. This is the nasal septum cartilage. As you can see when you touch it, the tip of the nasal septum cartilage does not reach the tip of the nose. The nasal wing cartilage, which forms the tip of the nose, is not directly connected to the nasal septum cartilage, so the tip of the nose can be moved up, down, left, or right.

It is the key to successful surgery.

The frame should be as tight as possible to withstand the force of the skin's return."

Consider creating a

The least mobile of the tissues comprising the nasal tip is the nasal septal cartilage. The nasal bones and maxillary bones are more compact tissues, but they are too far away from the nasal tip to be used in surgery.

What is nasal septal lengthening?

What is nasal septal lengthening?

'A scaffold with little movement that clicks right under your nose.'

It is a surgical procedure, the purpose of which is to

The nose tip should be able to withstand the force of the skin's attempts to lower and shorten, while sacrificing some of its own movement."

It is.

So, is nasal septum extension a must for all patients? Not so much.

When building, the foundation work required for a one-story house is different from that for a high-rise building, just as the foundation work required for a one-story house is different from that for a high-rise building.

The size and firmness of the nasal wing cartilage that frames it, and the thickness and softness of the skin that covers it, vary widely.

In cases where the skin is not too hard, the nasal wing cartilage is not too small, and the nasal septal cartilage is not too short, it is possible to create a frame that will resist the skin's ability to return without a nasal septal extension.

In cases of poor skin elongation, small nasal wing cartilage, or short nasal septal cartilage, the skin's ability to return will be defeated unless scaffolded with nasal septal extension.

Nasal septal extension is often used only as a result of the need for a strong frame for the purpose of lengthening the nose or making it more pointed, but depending on the conditions of the skin and cartilage, even mild changes may require nasal septal extension. On the other hand, if conditions are favorable, significant changes can be achieved without the use of a septal extension.

It is true that nasal septum extension is a major surgery and not inexpensive.

If the extension is forced, there is a risk of bending over against the skin's ability to return.

Applying nasal septum extension to everything would be a consideration.

summary

During the counseling, we listen to the patient's desired nasal shape, and then we propose the necessary surgical technique in light of the skin and cartilage requirements. For patients who wish to avoid nasal septum extension, we try our best to make a proposal that meets their wishes, but there are still cases in which we have no choice but to suggest nasal septum extension.

It is difficult for patients to determine for themselves what their nose looks like. It is difficult for patients to judge for themselves, so if you discuss this with us in a consultation, we will explain it to you thoroughly.

Assistant Director Daiki Kuroda

#: Dr. K's In-Depth Commentary Series