The Soft Triangle Tension Graft.

Background: Rhinoplasty surgeons often rely on tip grafting to add volume in the infratip, midtip, or supratip areas. The author has developed a novel tip graft, from the repurposed, pliable cephalic margins of the lower lateral cartilage lateral crura. The main purpose of the soft triangle tension graft (STTG) is to control tip tension of the medial crura, buttress the soft triangles, and add a small degree of volume to the tip.

Methods: A retrospective review was conducted identifying all patients in whom the STTG was used. Basic demographics, operative reports, and complications were recorded.

Results: The STTG was used in 58 patients, including 53 women, with an average age of 33 years (range, 22 to 45 years) and average follow-up time of 12 months (range, 8 to 24 months). No postoperative complications-including graft malposition, migration, palpability, visibility, infection, alar notching, and surgical revisions-were evident on follow-up.

Conclusions: The novel STTG focuses on buttressing and controlling tension between the 2 medial crura and soft triangles rather than simply adding volume to the tip. The soft, pliable nature of the graft enables versatility. The STTG can be used even in thin-skinned patients with a favorable safety profile.

Clinical question/level of evidence: Therapeutic, IV.