Diced and Crushed Cartilage Plus Autologous Fibrin Matrix Obtained by a Simple Process for Dorsal Augmentation of the Mestizo Nose

Abstract

Several alternatives can be used for nasal dorsum augmentation. We report the use of crushed diced cartilage embedded in an autologous fibrin matrix. This construct is placed on the nasal dorsum and is gently molded according to the characteristics of each patient. Rhinoplasty and nasal dorsum augmentation were performed in 45 patients with Mestizo characteristics after a complete medical history and development of a surgical plan. A crushed diced cartilage autologous graft and an autologous fibrin matrix from peripheral blood processed using the Choukroun method was used. Pre- and postoperative photographs were taken at short- and long-term follow-up. Two separate variables were evaluated: reabsorption and irregularities. Three plastic surgeons evaluated the results, using a Likert scale: the first variable was considered very excellent in 88.9%, very good in 6.7%, good in 4.4% with no poor or very poor results. In the second variable, results were excellent in 88.9%, very good in 4.4%, good in 3.4%, and poor in 3.3% with no very poor results. Our patients carry a volume with an aesthetically pleasing contour and form with no changes over a mean follow-up period of 4 years. Long-term effectiveness continues to be the main topic of discussion; however, this method can be considered an alternative not only to augment but also to smoothen irregularities of the nasal dorsum. We used a simple method with good and stable long-term clinical results.

Complications of Diced Cartilage Wrapped in Blood Products in Rhinoplasty: A Meta-Analysis

“…In addition, 1 article was included through reference searching 26. Eleven articles were finally included for meta-analysis 11,26–35. The flow diagram explained the selection procedure (Fig.…”

“…26 Eleven articles were finally included for meta-analysis. 11,[26][27][28][29][30][31][32][33][34][35] The flow diagram explained the selection procedure (Fig. 1).…”

Rinoplastia en nariz mestiza, un desafío quirúrgico

“…La reducción ósea suele ser conservadora y se realiza, principalmente, con raspas 3 . Si existe un radix bajo con una pequeña convexidad dorsal, se ha sugerido utilizar un injerto de cartílago morcelado para rellenar este espacio y evitar bajar aún más la convexidad del dorso 3,5,6,[8][9][10]13,16 . También se pueden utilizar injertos dorsales onlay de cartílago o material aloplástico, como el politetrafluoroetileno expandido (Gore-Tex) o el polietileno poroso de alta densidad (Medpor), con una baja tasa de complicaciones y buenos resultados estéticos a largo plazo, aunque siempre se prefiere usar autoinjertos 5,6,8,9 .…”