Semih A K
Turkish Journal of Plastic Surgery - 2026;34(3):107-114
Background: Short-nose deformity is a complex issue in rhinoplasty, and lengthening is only possible with grafting. Besides, the successes and failures are not apparent over the midterm period and the predictors of dissatisfaction. Objective: This study examines 3-year outcomes of nasal lengthening rhinoplasty, timing of late complications, and the role of preoperative measures in predicting postoperative complaints. Materials and Methods: This retrospective cohort study was conducted at a tertiary care center. The study involved 100 short-nose lengthening rhinoplasty patients undergoing primary rhinoplasty from January 2022 to December 2024 and had a follow-up of up to 36 months. The study sample comprised 68 females and 32 males, and the median follow-up was 22 months. Methods were septal extension grafts, caudal septum pivot, and dorsal augmentation. Demographic characteristics, operative details, clinical measurements, and patient-reported outcome measures, including the Rhinoplasty Outcome Evaluation and the Standardized Cosmesis and Health Nasal Outcomes Survey, were collected. Postoperative complaints were categorized as esthetic or functional, and associations with sex and technique were analyzed. Results: Complaints in the postoperative phase were reported in 46% of patients, with 28% related to cosmetic issues and 18% to functional concerns. Forty-one percent of complaints occurred within the 1st postoperative year, of which 14 of 19 (74%) were esthetic in nature. Fifty-nine percent of complaints occurred between 12 and 36 months, divided evenly between esthetic (14) and functional (13) failures. There was no significant predictor of the type of complaint based on sex (P = 0.29; Cramer's V = 0.10). A random-forest model with exploratory accuracy (level = chance [0.54]; balanced accuracy = 0.50; k = 0.0031; P = 0.893). Conclusion: Nasal extension rhinoplasty is a challenging surgery, and most patients experience early cosmetic and subsequent functional problems. Consequently, postoperative dissatisfaction could not be reliably predicted using demographic or routine operative variables alone.
