Abstract
In both primary and secondary rhinoplasty, establishment or refinement of nasal dorsal aesthetic lines is of paramount importance. Many different techniques used to create a cosmetically acceptable nasal dorsum have been published. The material to be used in nasal dorsal contouring should create a harmonic contour and should be easily shaped, long-lasting, and resistant to infection. Resection of the hump yields an osseocartilaginous complex as a single unit when an osteotome is used. Use of a rasp gives a good amount of fragmented material comprising bone, cartilage, soft tissues, and blood. The authors used this material as a paste graft to refine the nasal dorsum in rhinoplasty and retrospectively evaluated the outcomes. A retrospective chart review of 77 patients who underwent this procedure between 2003 and 2009 was performed. The follow-up period ranged from 22 to 40 months (median, 28 months). The postoperative evaluations included clinical examination and digital photographic documentation. The satisfaction of each patient was assessed with a questionnaire completed at the 12th postoperative month. The described graft, which combines the advantages of cartilage and bone, was shown to be clinically durable. This combination also results in an ideal texture and consistency for molding due to its diced form. The texture of this graft enables the surgeon to give a final shape to the nasal dorsum bimanually. In this study, a paste graft was shown to be a versatile and reliable composite material for nasal dorsal contouring and refinement.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Similar content being viewed by others
References
Karaaltin MV, Orhan KS, Demirel T (2009) Fascia lata graft for nasal dorsal contouring in rhinoplasty. J Plast Reconstr Aesthet Surg 62:1255–1260
Guerrerosantos J, Trabanino C, Guerrerosantos F (2006) Multifragmented cartilage wrapped with fascia in augmentation rhinoplasty. Plast Reconstr Surg 117:804–812 discussion 813–816
Cárdenas JC, Carvajal J (2007) Refinement of rhinoplasty with lipoinjection. Aesthetic Plast Surg 31:501–505
Jackson IT, Yavuzer R (2001) AlloDerm for dorsal nasal irregularities. Plast Reconstr Surg 107:553–558 discussion 559–560
Bottini DJ, Gentile P, Donfrancesco A, Fiumara L, Cervelli V (2008) Augmentation rhinoplasty with autologous grafts. Aesthetic Plast Surg 32:136–142
Peer LA (1954) Diced cartilage grafts. J Int Coll Surg 22:283–291
Cottle MH (1951) Nasal surgery in children. Eye Ear Nose Throat Mon 30:32–38
Erol OO (2000) The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 105:2229–2241 discussion 2242–2243
Yilmaz S, Ercocen AR, Can Z, Yenidunya S, Edali N, Yormuk E (2001) Viability of diced, crushed cartilage grafts and the effects of Surgicel (oxidized regenerated cellulose) on cartilage grafts. Plast Reconstr Surg 108:1054–1060 discussion 1061–1062
Kelly MH, Bulstrode NW, Waterhouse N (2007) Versatility of diced cartilage-fascia grafts in dorsal nasal augmentation. Plast Reconstr Surg 120:1654–1659 discussion 1654–1659
Hamra ST (1993) Crushed cartilage grafts over alar dome reduction in open rhinoplasty. Plast Reconstr Surg 92:352–356
Daniel RK (2008) Diced cartilage grafts in rhinoplasty surgery: current techniques and applications. Plast Reconstr Surg 122:1883–1891
Daniel RK, Calwert JW (2004) Diced cartilage grafts in rhinoplasty surgery. Plast Reconstr Surg 113:2156–2171
Sadooghi M, Kouhi A (2009) Mastoid bone as a new graft material in rhinoplasty. Am J Rhinol Allergy 23:e42–e46
Jackson IT, Choi HY, Clay R, Bevilacqua R, TerKonda S, Celik M, Smith AW (1998) Long-term follow-up of cranial bone graft in dorsal nasal augmentation. Plast Reconstr Surg 102:1869–1873
Celik M, Haliloglu T, Baycin N (2004) Bone chips and diced cartilage: an anatomically adopted graft for the nasal dorsum. Aesthetic Plast Surg 28:8–12
Kayikcioglu A, Bitik O (2010) Recycling the dorsal hump: a simple technique to prevent dorsal ırregularities in primary rhinoplasty. Plast Reconstr Surg 126:73e–74e
Orak F, Senyuva C, Bayramicli M, Yucel A (1995) Reversed roof graft for the severely deviated nose. Aesthetic Plast Surg 19:31–36
Mottura AA (2002) Chin augmentation with nasal osteocartilaginous graft. Plast Reconstr Surg 109:783–787
Cingi C, Songu M, Thomas JR (2010) Augmentation mentoplasty with osteocartilaginous nasal graft. Otolaryngol Head Neck Surg 143:549–553
Gupta A, Lobocki C, Malhotra G, Jackson IT (2009) Comparison of osteogenic potential of calvarial bone dust, bone fragments, and periosteum. J Craniofac Surg 20:1995–1999
Baek RM, Eun SC, Heo CY, Min KH (2010) Rhinoplasty using rib chondro-osseous graft in asian patients. J Craniofac Surg 21:1122–1125
Gentile P, Cervelli V (2009) Nasal dorsum reconstruction with 11th rib cartilage and auricular cartilage grafts. Ann Plast Surg 62:63–66
Romo T III, Sclafani AP, Sabini P (1998) Reconstruction of the major saddle nose deformity using composite allo-implants. Facial Plast Surg 14:151–157
Conflict of interest
The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Orak, F., Baghaki, S. Use of Osseocartilaginous Paste Graft for Refinement of the Nasal Dorsum in Rhinoplasty. Aesth Plast Surg 37, 876–881 (2013). https://doi.org/10.1007/s00266-013-0182-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-013-0182-5