Tongue and Groove Technique for Nose Elongation

The Problem

Elongation of the short nose adds to the complexity of the rhinoplasty. Presented in this chapter is an extremely reliable technique of nose elongation with or without alteration of the projection.

The Background

Many techniques have been introduced for nose elongation, all of which were tried by the author with limited success. Septal extension grafts are notorious for instability, including rotation, overlap causing loss of initially attained nasal length, asymmetry if the graft is placed in one side of the septum, and rigidity if the septal extension segment is secured to the septum rigidly. Having faced all of these potential suboptimal outcomes, the author reported his experience with the tongue and groove technique for nose elongation in 2003. For the author, this technique has been the sole means of nose elongation for over three decades. There have been two minor modifications since the initial publication.

The Indications

Any patient with a short nose is a good candidate for the tongue and groove technique. This procedure not only enables elongation of the nose, but also facilitates correction of any deficiency in the tip projection.

The Surgery