Effect of Hammer Graft Technique on Outcomes of Rhinoplasty Cases

Background: Rhinoplasty is the most challenging facial surgery, evolving over the past 25 years. Initially, surgeons used reductive techniques to resize and reshape the cartilage and bone. Aim: To evaluate the effect of the hammer graft technique on outcomes of rhinoplasty cases especially on the nasal tip projection and rotation. Patients and methods: This prospective single arm study included 20 patients undergoing primary rhinoplasty with a weak or under-projected nasal tip, which could be attributed to heredity, trauma, or aging factors. Preoperative evaluation included detailed medical and surgical history to identify prior nasal trauma or surgeries, a thorough physical examination to evaluate nasal structure, tip projection, rotation, dorsal contour, and airflow, as well as standardized photographic documentation from multiple angles for analysis and comparison. Patient expectations were carefully discussed to align surgical goals, and in selected cases, advanced imaging or phenylephrine testing was performed to predict functional and aesthetic outcomes. Result: Regarding Total Rhinoplasty outcome evaluation questionnaire score distribution among the studied patients before and after surgery, there was highly statistically significant difference between studied group (P<0.001). Regarding total nose scoring distribution among the studied patients before and after surgery, there was highly statistically significant difference between studied group (<0.001). Conclusion: Hammer graft is a stable, single graft that effectively supports nasal tip projection, rotation, caudal septum, and dorsal stabilization in primary rhinoplasty.