Dr. Shinji Nagao Addresses Complex Nasal Surgery at JSAS 2026

On May 29, 2026, Dr. Shinji Nagao, the director of THE ROPPONGI CLINIC located in Minato, Tokyo, presented at the 114th Japanese Society of Aesthetic Surgery (JSAS). In this video session, he shared his expertise on advanced surgical techniques for challenging nasal deformities, including cases of septal deviation, thick skin, and revision surgeries.

Overview of the Lecture

- Session Name: Video Session 2
- Title: Approaches to Various Anatomical Characteristics in Rhinoplasty – Innovations at Our Clinic for Cases with Septal Deviation, Skin Thickness, and Revision Procedures
- Date: May 29, 2026, 9:35 AM – 10:05 AM
- Venue: Venue 2
- Chairperson: Dr. Tetsu Iwao (Sunset Medical Corporation)
- Speaker: Dr. Shinji Nagao (THE ROPPONGI CLINIC)

The Foundation of Rhinoplasty

Dr. Nagao emphasized the importance of creating a solid foundation when performing nasal surgeries. He articulated that achieving an ideal nasal tip is not merely about narrowing the tip but rather ensuring that the nasal support structure is appropriately aligned. His innovative approach includes a three-step method:

1. Reshaping Lower Lateral Cartilage (LLC)
2. Morphological Adjustments via Cartilage or Tissue Grafting
3. Soft Tissue and Skin Adjustments as Needed

He clarified that successful nasal tip refinement should not just chase after height or slenderness but should prioritize natural, anatomically sound designs that guarantee long-term stability.

Key Points in Septal Deviation and Extension Procedures

For patients with deviated septums, a significant challenge arises from the fact that correcting the septum can weaken the support structure while simultaneously placing undue stress during septal extension. Dr. Nagao outlined strategies to manage these conflicting issues:

- Ensure Adequate Strength of the Septum’s Foundation
- Minimize Load from Septal Extension
- Design with Long-term Stability in Mind

Unique Techniques for Severe Septal Deviation

Dr. Nagao introduced a specialized technique referred to as PSA TRIM + SCORING + SUTURING TECHNIQUE for correcting cases with severe septal deviation. This method is particularly useful for:

- Cases with Significant Deviations at the Anterior Nasal Spine (ANS) Attachment
- Pure Septal Size Mismatch Cases

The aim of this approach is to balance functional and aesthetic aspects, showcasing the necessity for tailor-made treatments that align with the unique anatomical features of each patient.

Comments from Dr. Shinji Nagao

Pursuing the aspiration to become a world-renowned surgeon, Dr. Nagao completed a Clinical Clerkship in Neurosurgery abroad before transitioning through general surgery, internal medicine, reconstructive surgery, and finally to aesthetic surgery. He articulated, “Rhinoplasty is not simply about creating height or slenderness; it’s crucial to accurately understand each patient’s anatomical features to construct the most suitable structure. Especially for challenging cases like septal deviations and revisions, ensuring long-term stability and a natural finish requires thoughtful design of the support structures.”

Moving forward, he aims to incorporate the latest insights both domestically and internationally to provide patients with safer and higher-quality rhinoplasty procedures.

About THE ROPPONGI CLINIC

- Location: 5th Floor, Uni Roppongi Building, 15-17 Roppongi 7-chome, Minato, Tokyo
- Contact: 03-6438-9244
- Surgical Specialties: Aesthetic Surgery