{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T10:11:20Z","timestamp":1776852680633,"version":"3.51.2"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,4,26]],"date-time":"2011-04-26T00:00:00Z","timestamp":1303776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2011,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Tip surgery remains the most difficult part of rhinoplasty in Asian patients because of the lower lateral cartilage characteristics and thick skin. The objective of this study was to evaluate the multilayer cartilaginous tip\u2010grafting technique used for tip refinement in Korean patients undergoing rhinoplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic tertiary care medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>A retrospective study of 99\u00a0Korean patients who underwent open rhinoplasty involving multilayer cartilaginous tip\u2010grafting for tip refinement was performed. Autologous septal, conchal, costal, or homologous costal cartilage, or a combination of these materials was used as grafting materials. Preoperative and postoperative photographs were reviewed for objective and subjective assessment of aesthetic outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among patients, 7 had undergone previous rhinoplasty (7.1%), and removal of the previously placed silicone graft was required in 5 patients (5.1%). Two (6.7%), 3 (61.5%), 4 (28.8%), and 5 (3.0%) layers of cartilaginous graft were used. Postoperative aesthetic outcomes were graded as excellent in 63.6%, fair in 28.3%, and no change\/worse in 8.1% of cases. Preoperative and postoperative objective measurements showed that the procedure resulted in increased nasal tip projection (0.52 \u00b1 0.06 vs 0.57 \u00b1 0.05; <jats:italic>P<\/jats:italic> &lt;. 05) and improved nasolabial angle (92.98\u00b0 \u00b1 9.95\u00b0 vs 95.34\u00b0 \u00b1 8.20\u00b0; <jats:italic>P<\/jats:italic> &lt;. 05). The overall complication rate was 12.1%, and 8 patients required revision surgery (8.1%). Complications included infection (5.1%), visible graft contour (1.0%), nostril deformity (1.0%), overprojection (2.0%), and visible hypertrophic scar at the marginal incision site (3.0%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The multilayer cartilaginous tip\u2010grafting technique was found to be effective for aesthetic refinement of the nasal tip when used in rhinoplasty for Korean patients.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599811406484","type":"journal-article","created":{"date-parts":[[2011,4,26]],"date-time":"2011-04-26T22:07:16Z","timestamp":1303855636000},"page":"217-222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["A Multilayer Cartilaginous Tip\u2010Grafting Technique for Improved Nasal Tip Refinement in Asian Rhinoplasty"],"prefix":"10.1002","volume":"145","author":[{"given":"Yong Ju","family":"Jang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u2010Young","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bedy Chung","family":"Lau","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology University of British Columbia Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,4,26]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2006.06.014"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197507000-00007"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198301000-00007"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.01.009"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198802000-00017"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.6.2.120"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-36492"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199809020-00052"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199101000-00010"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/03655230701624996"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200005000-00057"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-008-9114-1"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000287329.13026.1f"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2009.11.018"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archfaci.1.4.312"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20817"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599811406484","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599811406484","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599811406484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:27:33Z","timestamp":1760970453000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599811406484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,4,26]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,8]]}},"alternative-id":["10.1177\/0194599811406484"],"URL":"https:\/\/doi.org\/10.1177\/0194599811406484","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,4,26]]},"assertion":[{"value":"2011-01-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-04-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}