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2025.12.18
Why are tip rhinoplasty and septal extension performed as a set?
As a board-certified plastic surgeon, I have handled numerous cases involving trauma, reconstruction, and congenital conditions, cultivating precise techniques and deep anatomical understanding. Driven by the desire to deliver the transformative power of beauty—where visible change uplifts the spirit—I pursued a career in cosmetic surgery. My areas of expertise include comprehensive eye treatments, injectable therapies, and anti-sagging procedures. Guided by a commitment to sincerely address each patient's aspirations, I provide meticulously crafted treatments focused on achieving beauty.
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Designing natural beauty with trust.
I am Masataka Fujihashi, a board-certified plastic surgeon.
When researching rhinoplasty, I often come across the combination of "nasal tip reshaping + septal extension."
Septoplasty and rhinoplasty are typically performed as a combined procedure.
Rather than performing either one alone, it is only by performing them simultaneously that a truly complete result is achieved.
The reason is simple: these two surgeriesA relationship where roles differ and complement each otherbecause it is located there.
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■ What is Rhinoplasty?
Nasal tip rhinoplasty is a procedure that involves manipulating the cartilage at the tip of the nose (the alar cartilage) to refine the tip or reshape it.
I want to improve my bulbous nose.I want to make my nose tip look sharper,This procedure is designed to achieve such goals and can be described as surgery that reshapes the tip of the nose itself.
However,Rhinoplasty is solely for the tip of the nose.Shape adjustmentcentered aroundis.
There are basically no changes such as extending the nose forward or significantly altering the direction.
Source: 'Cosmetic Surgery Techniques: Rhinoplasty, 1st Edition' (Kakuseido Publishing Co., Ltd., 2012) p.98 (Figure modified and reproduced)
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■ What is Nasal Septum Extension?
Nasal septum extension involves fixing the transplanted cartilage to the nasal septum,Surgery to create a foundation that allows three-dimensional control of the position and orientation of the nasal tipis.
Before shaping the nose tip through rhinoplasty, it plays a structural role in determining "where and in what direction to position the nasal tip."
The design of the nasal tip is not solely determined by rhinoplasty.
How much to extend, in which direction to extend, and whether the supporting structure has sufficient support and stability are crucial.
If you merely shape something without sufficient supporting structure, it may be difficult to achieve change or become unstable over time.
Therefore, in nasal septum extension, it is crucial to design not only the cartilage structure but also the balance with the skin and soft tissue (envelope).
Source: 'Rhinoplasty, First Edition' (Sankei Publishing Co., Ltd., 2017), p.248, Figure 11-39, reproduced with modifications.
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■ Why is one alone insufficient?
Performing only a nasal septum extension may alter the position or angle of the nasal tip, but it may not sufficiently refine the tip's detailed shape or contour.
On the other hand, even if only the nasal tip is reshaped, if the supporting structure beneath the tip is weak,Sometimes the changes aren't as noticeable as expected, or the shape becomes unstable over time.
In other words,
・Septal extension: Structurally determines the position and direction of the nasal tip
・Nasal tip reshaping: To refine the shape of the nasal tip
There is a division of roles, and in many cases, it is difficult to complete the task with just one person.
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■ Benefits of Performing as a Set
Extend the nasal septum to stabilize the position and direction of the nasal tip, then refine its shape through tip rhinoplasty.
By performing the surgery in this order,
・Sufficient amount of change
・Long-term stability
・Naturalness that blends seamlessly with facial expressions
These can be achieved in a well-balanced manner.
Therefore, nasal tip reshaping and septal extension are typically performed as a set.
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■ Not necessary for everyone
Of course, not everyone requires both nasal tip reshaping and septal extension.
In cases where only a slight adjustment to the shape of the nasal tip is necessary, rhinoplasty targeting the nasal tip alone may be sufficient.
What matters is "where and how much you want to change."
The goal is to select the necessary surgery according to the specific purpose.
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■ Summary
Rhinoplasty and septal extension are often performed together because they are complementary procedures with distinct roles: one reshapes the nose, while the other provides structural support.
Designing not only for visual changes but also for stability and texture leads to highly satisfying rhinoplasty results.
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【Profile】
Masataka Fujihashi, MD, Plastic Surgeon
Leveraging expertise as a board-certified plastic surgeon, I offer comprehensive facial cosmetic procedures including eyelid and nose surgery, facial liposuction, thread lifts, and hyaluronic acid injections. From incisional surgeries and revision procedures requiring delicate design to minimally invasive injections and lifts with minimal downtime, I strive to provide treatments tailored to each patient's ideal outcome.
We are dedicated to achieving natural results and minimizing downtime, pursuing medical care that leaves you feeling confident in your choice through sincere consultations.
Designing natural beauty with trust.
We cherish that sentiment and apply it to our daily practice.
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【Career】
March 2015: Graduated from the School of Medicine, Showa University
April 2015 Showa University Yokohama Northern Hospital Initial Clinical Training
April 2017 Showa University Hospital Department of Plastic Surgery
October 2017 Maebashi Red Cross Hospital Plastic Surgery / Cosmetic Surgery
April 2019 Nishio Municipal Hospital Plastic Surgery Department
April 2020 Showa University Fujigaoka Hospital Plastic Surgery Department
November 2020 Ota Nishinouchi Hospital Plastic Surgery / Cosmetic Surgery
July 2022 Tokyo Rosai Hospital Plastic Surgery / Cosmetic Surgery Department Head
July 2022: R.O.clinic (Part-time), Kusano Taro Clinic (Part-time)
April 2024 Deputy Director, Ginza TA Clinic
November 2025 BIANCA CLINIC
【Professional Affiliations and Qualifications】
Japanese Society of Plastic and Reconstructive Surgery Board-Certified Plastic Surgeon
Member of the Japanese Society of Aesthetic Plastic Surgery (JSAPS)
Member of the Japanese Society of Aesthetic Surgery (JSAS)
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