Extensor Septal 2024: Enfoque Submamario Para cartílago Costal. Rinoplastia Holística

Background: Rhinoplasty in patients with severe saddle nose deformity, short nose, or significant caudal septal deficiency presents a significant reconstructive challenge, often requiring robust structural support. Conventional graft sources such as septal or auricular cartilage are frequently insufficient for major reconstructions, while traditional costal cartilage harvesting is associated with visible scarring and donor-site morbidity. Objective: This study introduces and evaluates the "Septal Extender 2024" technique, a novel holistic rhinoplasty method utilizing costal cartilage harvested via a discrete submammary approach. The technique aims to provide reliable structural support while minimizing graft warping and donor-site scarring. Methods: A retrospective analysis was conducted on 65 consecutive patients undergoing complex rhinoplasty with the Septal Extender 2024 technique. The protocol includes a concealed submammary incision for cartilage harvest, a proprietary carving and lamination protocol to neutralize internal cartilage tension and prevent warping, and secure multi-point fixation of the graft to restore dorsal support, tip projection, and rotation. Outcomes were assessed preoperatively and at 6 months postoperatively using standardized 3D photogrammetry, patient-reported outcome measures (FROI-17, NOSE scale), independent surgeon evaluation (ROE), and donor-site scar assessment (POSAS, VAS). Results: The mean follow-up period was 9.3 months. There were no cases (0%) of clinically significant graft warping or resorption. Nasal function improved significantly, with mean FROI-17 scores decreasing from 52.3 to 24.1 (p < 0.001) and NOSE scale scores from 68.2 to 17.5 (p < 0.001). Aesthetic outcomes were excellent (mean ROE score: 84.6/100). Donor-site morbidity was minimal, with high patient satisfaction (VAS: 9.2/10) and no hypertrophic scarring. Conclusion: The Septal Extender 2024 technique provides a holistic, reliable, and reproducible solution for complex nasal reconstruction, effectively addressing structural deficiencies while optimizing aesthetic outcomes and minimizing donor-site morbidity through a concealed submammary approach.