The Evolution of Nasal Stents in Eastern Rhinoplasty: From Adoption of Western Endogenous Extension Stents to Indigenous Development of Exogenous Extension Stents

Rhinoplasty ranks among the most commonly performed aesthetic and reconstructive surgical procedures worldwide. However, fundamental anatomic differences exist between Eastern and Western nasal structures-particularly with respect to skeletal support, soft-tissue thickness, cartilage elasticity, and culturally influenced aesthetic ideals. Nasal stents serve as the core structural foundation for modifying nasal dorsum contour, tip projection, and columellar length; consequently, they critically influence surgical success rates, postoperative aesthetic outcomes, and long-term structural integrity following rhinoplasty. This review systematically traces the evolutionary trajectory of nasal stent techniques in Eastern rhinoplasty-from the initial adoption and localized adaptation of Western endogenous extension stents, through the recognition of their inherent anatomic and functional limitations in Eastern patients, to the subsequent development of exogenous extension stents expressly designed to accommodate Eastern nasal anatomy. We provide an in-depth comparative analysis of both stent categories, examining their anatomic rationale, technical principles, clinical advantages, complication profiles, and key developmental milestones-with particular emphasis on the paradigm shift from passive replication of Western techniques toward autonomous, evidence-informed innovation.