Unilateral Septal Extension Graft and Bilateral Septal Extension Graft in Droopy Tip and Its Effect on Tip Deviation

The Nasal tip from an aesthetic perspective is one of the most visible nd defining features of the nose, Even with a well- shaped dorsum; a droopy, asymmetric or poorly supported tip can distort the overall appearance of the nose; as it play a key role in projection and rotation -the primary parameters that contribute to nasal attractiveness . Functionally the nasal tip is structurally essential for maintaining airway patency, A weak or collapsed tip can result in external nasal valve collapse leading to breathing issues .

The nasal tip is supported by several mechanisms including: the length and integrity of the lower lateral cartilages, the medial crural attachment to the septal cartilage, the connection to the upper lateral and lower lateral cartilages, the nasal membranous and cartilaginous septum, the anterior nasal spine, and the lateral crural attachment to the nasal aperture , Tip plasty is crucial as it ensures that the nose not only appears proportionate and aesthetically pleasing, but also functions properly, and maintains long-term structural support. Neglecting the nasal tip can result in an unnatural or imbalanced outcome even when the rest of the nose is well-shaped .

In primary rhinoplasty, the nasal tip is often the centeral cus for achieving a refined yet natural look. Tip plasty often includes several mechanisms such as (e.g., Colum umellar strut graft, septal extensions graft these are used to support or reposition the tip without compromising function. The Septal Extension Graft is considered one of the most reliable technique offering a wide range of applications. However, it may be associated with some drawbacks such as the tip's stiffness and potential aesthetical or functional issues. This study aims to compare between the unilateral and bilateral septal extension graft and evaluate the effect of each of them on tip deviation.

Inclusion criteria

• Patients above 18years
• Aesthetic complain related to nasal tip
• presented for primary rhinoplast.

Exclusion criteria

• Patients under 18year old
• Patients need extensive nasal reconstructions lacking septal cartilage
• Patients with severely deficient cartilaginous septum.