Background:Autogenous costal cartilage is a good option for large volume requirements in rhinoplasty, when septal or conchal cartilages do not suffice. Reluctance to use costal cartilage is due to apprehension of warping. However, warping can be avoided if we follow the principle of balanced section as advocated by Gibson and Davis. “Warping” can also be utilized to change the curvature of the graft.Materials and Methods:We have used 69 costal cartilage grafts as a solid piece for contour fill in rhinoplasty in 31 patients over the last 10 years. Principle of balanced section as advocated by Gibson and Davis was adhered to while carving the grafts, however some grafts were allowed to warp to get different sizes and shapes.Results:All the procedures were uneventful. Aesthetic appearance of all patients was satisfactory and acceptable to all the patients. In two cases, the dorsal graft minimally shifted to one side, but remained straight. In one patient, there was late appearance of distortion.Conclusion:The mode of cartilage warping is predictable and it can be used to advantage. Apprehension to use costal cartilage graft is unjustified, as with precision carving a desired shape can be obtained.

Penile amputation is an uncommon injury for which immediate surgical replantation is warranted. Microsurgical replantation is the “standard” method for penile replantation. Early replantation yields a high success and low complication rate. We report a case of a 34-year-old male who presented with amputation at the proximal penile shaft which was successfully replanted using microsurgical techniques. Minor skin necrosis was noted post-operatively which was debrided and covered with skin graft. Follow-up at 6 months showed satisfactory cosmetic appearance, normal voiding, return of sensations and erectile function. The level of evidence was V.

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Advances in head and neck reconstruction techniques have improved the results in function and the aesthetic outcome. Several flaps with different composition are available for specific reconstruction to achieve optimum result. Sensate free tissue transfer, dental rehabilitation and epiphyseal transfer for pediatric mandible are also now possible to achieve better function. The specific choice of the flap according to the region of defect and important keypoints in harvesting and reconstruction strategy for head and neck cancer are based on our experience in the last two decades.

Advances in head and neck reconstruction techniques have improved the results in function and the aesthetic outcome. Several flaps with different composition are available for specific reconstruction to achieve optimum result. Sensate free tissue transfer, dental rehabilitation and epiphyseal transfer for pediatric mandible are also now possible to achieve better function. The specific choice of the flap according to the region of defect and important keypoints in harvesting and reconstruction strategy for head and neck cancer are based on our experience in the last two decades.