Bone Chips and Diced Cartilage: An Anatomically Adopted Graft for the Nasal Dorsum

Abstract

Since 1996, cranial bone chips or septal bone chips harvested during septal deviation surgery and small chips of ear or septal cartilage have been used in 67 patients for dorsal nasal augmentation or for smoothing dorsal nasal irregularities. In this study, 59 overresections of ostecartilaginous nose structures during previous aesthetic nose surgeries and 8 primary rhinoplasties occasioned the use of bone or cartilage grafts. For 57 patients both bone and ear cartilage grafts were used for the reconstruction. Bone grafts were used for seven cases and cartilage grafts for three cases. The results from 7 years, of experience with this method of nasal dorsum reconstruction were satisfactory and durable. The most important advantage of this method is that the bony side of the nose is reconstructed with bone and the cartilage side with cartilage. Another advantage is that the bone chips are incorporated with both nasal bones, building a strong dorsal nasal bony mono-black. This technique also is useful for augmenting mild saddle nose deformity and dorsal nasal projection deficiency on the bony part, cartilage part, or both parts.

Comparison of Autogenous Cartilage, Acellular Dermis, and Solvent-Dehydrated Pericardium for the Prevention and Correction of Dorsal Nasal Irregularities: An Experimental Study

“…Insufficient resection of the bony and cartilage hump is easily solved by additional resection, whereas overresection results in a more complicated problem due to the distortion or destruction of the appropriate structure of the osteocartilaginous components. Grafts are almost always needed for reconstruction of destroyed structures [13]. Additionally, grafts are also needed to mask dorsal irregularities on osteotomy lines in patients with thin skin, even if appropriate resections were carried out.…”

“…In patients with thin skin, graft materials are occasionally used in primary rhinoplasty procedures for the prevention of visible dorsal nasal irregularities [1][2][3][4][5][6]. Cartilage, dermis, temporal fascia, superficial musculoaponeurotic system (SMAS), Vicryl mesh, gelatin film, polytetrafluoroethylene, Surgicel-wrapped diced and crushed cartilage, tensor fascia lata, and acellular dermis are among the most commonly used materials to correct contour deformities and provide a subcutaneous pad [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Each material has certain advantages and disadvantages but a controversy about the ''best material'' still exists.…”

Cortical Tibial Bone Graft for Nasal Augmentation

“…Cartilage grafts in augmentation rhinoplasty are useful for mild deformities, but autogenous bone is used if a greater augmentation is required [5,6]. The most frequent defects are graft displacement and asymmetry, tendency to curl (especially rib cartilage), a visible step, and under-or overcorrection [7,10].…”

“…Augmentation rhinoplasty procedures have an important limitation in the use of bone or cartilage grafts, which have different rates of resorption over time. Different grafting materials have been used for augmentation rhinoplasty, such as alloplastic implants, temporalis fascia, dermofatgrafts, cartilage (from septum, rib or concha) or bone(cranial bone, iliac crest and rib) [1][2][3][4][5][6][7][8][9]. We propose the use of the tibial bone as a cortical bone graft donor site not usually described for the purpose of augmentation rhinoplasty.…”

A New Technique to Correct Saddle Nose Deformity in Failure of Diced Cartilage Grafts: Diced Cartilage Flap

“…Despite the fact that rhinoplasty is one of the most common esthetic procedures in the world, we still encounter a considerable number of secondary and tertiary rhinoplasty patients in our practice [1]. If the problem of secondary rhinoplasty patients is under-resection, it can be simply solved by resection of the excessive tissues.…”