Elastic Double Arch Model-Guided Alar Cartilage Reinforcement With Ligamentous Reconstruction in East Asian Rhinoplasty: A Multicenter Prospective Observational Study.

BACKGROUND: Conventional structural rhinoplasty can provide reliable nasal tip support but may increase stiffness and restrict physiologic tip mobility, particularly in East Asian patients requiring projection and lengthening. OBJECTIVES: To evaluate the aesthetic, functional, and dynamic outcomes of an Elastic Double Arch Model-guided rhinoplasty technique in East Asian patients undergoing primary or revision rhinoplasty. METHODS: This multicenter prospective observational study enrolled 213 consecutive East Asian patients who underwent primary or revision rhinoplasty using thin cortical costal cartilage grafts for alar arch reinforcement combined with nasal tip ligamentous reconstruction. Fifteen patients were lost to follow-up, leaving 198 patients for final analysis, including 72 primary and 126 revision cases. Outcomes included VAS-cosmetic, FACE-Q Rhinoplasty Module, VAS-functional, NOSE score, quantitative nasal tip mobility, and complications. RESULTS: Aesthetic and functional outcomes improved significantly in both groups. Among patients with available 36-month data, VAS-cosmetic improved from 5.02 ± 0.88 to 8.40 ± 0.85 and FACE-Q from 42.5 ± 8.6 to 84.2 ± 7.5 in primary cases; corresponding values improved from 4.87 ± 0.91 to 8.20 ± 0.92 and from 40.2 ± 9.1 to 81.5 ± 8.2 in revision cases. Functional scores also improved. Nasal tip mobility was preserved in primary cases and markedly restored in revision cases. Complications were uncommon. CONCLUSIONS: This anatomically integrated technique was associated with improved aesthetic and functional outcomes while preserving or restoring clinically meaningful nasal tip mobility in selected East Asian rhinoplasty patients.