Journal archive · Revision and secondary rhinoplasty · Nasal tip · Septum, valve and airway · 2025
The Shield-Like Septal Extension Graft: A Novel Technique for Nasal Tip Management in Revision Rhinoplasty
Balikci H, Yenigun A, Polat E, Dogan R, Ozturan O.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on tip onlay graft.
From the abstract
“This study introduces the shield-like septal extension graft technique, a novel approach for enhancing tip support, rotation, and projection in revision rhinoplasty cases. The shield-like septal extension graft is positioned in front of the caudal septum, mimicking a shield graft to provide structural reinforcement.…”
Excerpt; the full abstract is on PubMed.
Citation
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Revision and secondary rhinoplasty
Between 5% and 15% of rhinoplasties are done again, and the published series say the second operation is a different problem from the first: the cartilage is gone, the skin is scarred and less able to survive, and the airway is usually part of the complaint.
Nasal tip
Tip surgery is now a support problem rather than a sculpting problem: the septal extension graft holds projection and rotation where the columellar strut loses them (0.2% against 4.7% projection loss at one year), and the current series repair, reposition and reinforce the lower lateral cartilages instead of excising them.
Septum, valve and airway
Every rhinoplasty is a breathing operation whether it intends to be or not: the septum holds the nose up as well as dividing it, and the narrowest part of the whole airway is the internal valve the surgeon is standing over.
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