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Multilayered Costal Cartilage Graft for Nasal Dorsal Augmentation

Abstract

Background

Nasal dorsal augmentation is one of the most commonly performed rhinoplasty procedures in Asia. We describe our experience with multilayered costal cartilage grafting (MCG) for dorsal augmentation in Asian patients. We aimed to evaluate the aesthetic outcomes and complications of MCG in comparison with those of one-block concentric carving costal cartilage graft (OCG) using objective and subjective assessment criteria.

Methods

Eighty-two consecutive patients who underwent dorsal augmentation with OCG (n = 39) or MCG (n = 43) by a single surgeon between November 2010 and September 2018 with > 12 months of follow-up were included in this retrospective cohort study. The aesthetic outcomes, which were determined by both anthropometric analysis and consensus decision, were compared. Patients’ satisfaction and postoperative complications were also analyzed.

Results

Dorsal height ratios and radix height ratios increased significantly by 14.0% and 19.4%, respectively, after the OCG technique (p < 0.001) and by 13.5% and 19.0%, respectively, after the MCG technique (p < 0.001). Anthropometric comparison revealed that OCG did not show any significant differences in dorsal height ratio (p = 0.707) and radix height ratio (p = 0.856) postoperatively when compared with MCG. However, the warping rate was higher in the OCG (15.4%) than in the MCG (4.7%) group, although not significantly. There were no differences in overall patient satisfaction between the two groups.

Conclusions

Dorsal augmentation with MCG produces similar aesthetic outcomes but a lower warping rate than that with OCG. The MCG technique may minimize graft warping and thus might be an effective alternative for nasal dorsal augmentation, particularly in Asian rhinoplasty.

Level of Evidence IV

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Correspondence to Man-Koon Suh.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards, and all patients provided written informed consent prior to enrollment.

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Video 1. Surgical Techniques of Multilayered Costal Cartilage Grafts. (WMV 218564 kb)

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Namgoong, S., Kim, S. & Suh, MK. Multilayered Costal Cartilage Graft for Nasal Dorsal Augmentation. Aesth Plast Surg 44, 2185–2196 (2020). https://doi.org/10.1007/s00266-020-01712-3

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Keywords

  • Asian rhinoplasty
  • Dorsal augmentation
  • Rib cartilage graft
  • Multilayered graft