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Surgical Technique |

The Anchor Graft:  A Novel Technique in Rhinoplasty

C. W. David Chang, MD; Richard E. Davis, MD
Arch Facial Plast Surg. 2008;10(1):50-55. doi:10.1001/archfacial.2007.8.
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We review our use of a modified tip graft that we termed the anchor graft for the correction of nasal tip deformities. This modified infratip shield graft was used to improve alar rim positioning, while simultaneously improving tip projection and/or augmenting infratip fullness. Standardized preoperative and postoperative photographs were taken of each patient. Aesthetic appearance was subjectively judged by the physician and a patient survey. Complications were tabulated. Sixteen patients met the requirements for inclusion in our study. Eleven patients received follow-up for more than 1 year. All patients demonstrated good aesthetic improvement, with only minor complications. No extrusion of the graft was noted. All patients reported a natural-appearing and normal-feeling nose after a minimum follow-up of 6 months. Revision surgery was elected in 4 patients, 2 of whom initially presented as revision cases. The anchor graft is a new technique to aid in cosmetic modification of the nasal tip as well as to improve the functional and aesthetic appearance of the nasal ala and external nasal valve.

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Figure 1.

Placement of the anchor graft. A, The anchor graft sits caudal to the medial crus and is sutured to the columella strut complex. B, The lateral crura are then attached to the arms of the graft to maintain a more caudal position.

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Figure 2.

A 45-year-old woman who presented with difficulty in breathing after undergoing 1 previous rhinoplasty. A through C, Preoperative views. D through F, The 6-month postoperative results show improvement of tip architecture and relief from tip pinching.

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Figure 3.

A 48-year-old man who presented with alar retraction and severe nasal tip pinching after undergoing 1 previous rhinoplasty. A through C, Preoperative views. D through F, The 2-year postoperative views show a more caudal position of the ala as well as improvement of tip aesthetics. Admittedly, the reduction of columella show was too aggressive, as can be seen in the postoperative lateral views.

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Figure 4.

A 54-year-old woman who presented with obvious pinching of the nasal tip after undergoing 1 previous rhinoplasty. A through C, Preoperative views. D through F, The 6-month postoperative results show the restoration of a natural-appearing tip.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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