Transition Ramp Graft: A Simple and Effective Solution for Transitional Concavity Between the Nasal Dorsum and Tip Projection Grafts

Abstract

Background: Contour irregularities at the dorsum-tip junction remain a challenge in primary, secondary, and cleft-related rhinoplasty, particularly in patients with scarring or shortened soft tissues. While this transition irregularity can often be reduced by lowering the dorsum in standard cases, it becomes problematic in heavily scarred patients who require long septal extension grafts to achieve adequate tip projection, thereby increasing the risk of an abrupt and aesthetically unfavorable dorsum-tip transition. To address this issue, we evaluated the Transition Ramp Graft, a small structural onlay designed to equalize the height between the dorsum and tip and improve contour harmony in anatomically complex cases.

Methods: A retrospective review was conducted on patients who underwent open structural rhinoplasty with placement of the Transition Ramp Graft (TRG). Surgeon-based evaluations and patient-reported outcomes were assessed at 12 months.

Results: The TRG was applied in 56 patients. Surgeons reported excellent contour continuity, and patient satisfaction was high. No graft-related complications were observed.

Conclusions: The TRG provides a simple and reliable method for correcting dorsum-tip height discrepancies and improving contour harmony.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).