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Use of an Augmentation Spreader Graft for Management of Nasofacial Angle in Patients With Pseudo-Hump

Kim, Baek-Kyu, MD*; Han, Jihyeon, MD*†

doi: 10.1097/SAP.0000000000001773
Aesthetic Surgery
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Background Correction of the hump nose entails more than just simple elimination of the dorsal hump. Recent trend is toward conservative reduction of the hump and appropriate adjustment of the radix height. East Asians often present with pseudo-hump due to underprojected radix or tip, which accentuates the height of the hump. This study introduces our method of pseudo-hump correction and achieving a balanced nasal profile with minimal reduction of the hump and augmentation of the dorsum and tip with a modified augmentation spreader graft.

Methods A retrospective review was conducted of 97 consecutive cases of Korean patients undergoing hump reduction with simultaneous augmentation of the radix with resected hump fragments and augmentation of the nasal dorsum with augmentation spreader graft. No implants were used in any of the patients. Anthropometric analysis was performed, and patient satisfaction was evaluated at postoperative 1 year.

Results Postoperatively, hump was eliminated, and the dorsum and tip were successfully elevated using only autologous septal cartilage. The radix was augmented without surface irregularity or graft visibility. Nasal dorsum, tip, and radix projection increased significantly after surgery. Subjective evaluation revealed a high level of satisfaction in 84%.

Conclusions Our multipurpose bilateral augmentation spreader graft positioned above the septal plane was effective in dorsal and tip augmentation without the need for alloplastic material. Conservative hump reduction combined with augmentation of the relatively deficient areas of the nose produces a balanced nasal profile.

From the *Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Gyeonggi-do; and

Department of Plastic and Reconstructive Surgery, Kwandong University College of Medicine, International St Mary's Hospital, Incheon, Republic of Korea.

Received June 22, 2018, and accepted for publication, after revision October 23, 2018.

The abstract of this work was presented at Plastic Surgery the Meeting, October, 2017 at Orlando, FL.

Both authors have worked together on the article and have made substantial contributions to the following: conception and design of the study and acquisition of data, analysis, and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be submitted.

Conflicts of interest and sources of funding: none declared.

Reprints: Jihyeon Han, MD, Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gumi Ro 173 Road 82, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea. E-mail: jollyjulie@gmail.com.

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