DOI: 10.65396/ejra.1965316 ISSN: 2636-8072

Comparative Performance of Septal Extension Graft Techniques in Rhinoplasty: A Retrospective Analysis of Nasal Tip Rotation, Projection, Functional Outcomes, and Patient Satisfaction

Gürcan Sünnetçi, Ahmet Altuntaş, Mesut Yeşilova
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ObjectiveSurgeons can now manage the projection, rotation, stability, and long-term aesthetic results of the nose using extension grafts, which are crucial components of structural rhinoplasty. Several extension graft methods have been published, but there is a lack of comparable clinical evidence. The purpose of this research was to evaluate the three different extension graft methods, namely Classic Septal Extension Graft (SEG), Full-Transfixion Septal Extension Graft (FT-SEG), and Extended Spreader Extension Graft (ESEG), in terms of their effectiveness and aesthetic results.MethodsRoughly 90 individuals who underwent rhinoplasty between 2022 and 2025 comprised the study's retrospective comparison cohort. Each of the three groups of patients (n=30 per group) was randomly assigned to a different extension graft technique. The Integrated Nasal Tip Aesthetic Score (INTAS), nasolabial angle, and tip projection ratio were the main outcome measures. Evaluation of Nasal Obstruction Symptoms (NOSE), Rhinoplasty Outcome (ROE), patient satisfaction, complications, and revision rates were included as secondary outcomes. There was a comparison of pre- and post-operative results across groups.ResultsAll three methods markedly enhanced nostril tip rotation, projection, functional results, and patient satisfaction. The FT-SEG group had significantly higher final INTAS scores (51.6 ± 2.3) compared with the SEG (47.8 ± 2.6) and ESEG (46.3 ± 2.9) groups (p < 0.001). The group that received FT-SEG had the highest level of patient satisfaction (9.4 ± 0.4; p < 0.001). All groups showed functional improvement as measured by NOSE scores; the SEG and FT-SEG groups had lower NOSE ratings. There was little variation in the rates of complications and revisions across the groups.ConclusionThe cosmetic and functional results of any extension graft method were satisfactory. Patient satisfaction was higher, and objective aesthetic performance was better with the Full-Transfixion Septal Extension Graft, despite similar functional outcomes. These results provide further evidence that FT-SEG may improve the long-term control of tip projection and rotation in structural rhinoplasty.

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