Download PDF
Facial Plast Surg
DOI: 10.1055/a-2812-3575
Original Article

The Importance of Tip Support and The Caudal Septal Extension Graft

Authors

  • Kieran Boochoon

    1   Facial Plastic and Reconstructive Surgery, Texas Center for Facial Plastic and Laser Surgery, San Antonio, United States

  • Jose Enrique Barrera 

    2   Facial Plastic Surgery, Texas Center for Facial Plastic and Laser Surgery, San Antonio, United States
    3   Surgery, Uniformed Services University, Bethesda, United States (Ringgold ID: RIN1685)
Further Information
Also available at
 PDF Download

Aims and Backgrounds: The dynamics of nasal tip aesthetics and function is a complex balance of inherent cartilage structure and surrounding soft tissue characteristics. A thorough understanding of form and function is paramount in achieving optimal rhinoplasty results. Controlling the appearance and the shape of the nasal tip remains a challenging task for surgeons. Techniques: This paper discusses the caudal septal extension graft (CSEG) as a useful tool for controlling nasal tip projection, rotation, nasal length, and shape in rhinoplasty. Additionally, we highlight the importance of cephalic turn in flaps as a preservation technique to achieve aesthetic results while maintaining nasal function. Conclusions and Clinical Relevance: We discuss the role of the CSEG in cosmetic and functional rhinoplasty while highlighting improvements in patient related outcome measures (PROMs). In conclusion, the CSEG and cephalic turn in flaps demonstrate effective techniques to improve tip control and achieve more predictable and long-lasting rhinoplasty results.



Publication History

Received: 12 November 2025

Accepted after revision: 11 February 2026

Accepted Manuscript online:
16 February 2026

© . Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA