Frequently Used Grafts in Rhinoplasty: Nomenclature and Analysis

Abstract

In this article, the authors present the grafting techniques most commonly used to sculpt the nasal framework in primary and secondary rhinoplasty. The grafts are described in terms of their nomenclature, anatomical location, and clinical indications, presenting a simple and easy-to-reference guide for both beginners and expert surgeons.

Anatomical Variations of the Upper Lateral Cartilages and Their Implications in Rhinoplasty

“…There are different definitions of the appropriate length of the spreader grafts [17][18][19], but it should run the entire distance of the caudal aspect of the upper lateral cartilages (caudal to the nasal bones) to avoid a step deformity and to allow proper effectiveness. This study illustrates that anatomical variations of the cephalic border and the caudal border of the upper lateral cartilages may be more common than previously described.…”

Nasal Measurements in Asians and High-Density Porous Polyethylene Implants in Rhinoplasty

“…Gunter et al 17 stated that a columellar strut can be used to maintain tip support, improve tip projection, and help in shaping the columellar-lobular angle. Septal and rib cartilage are preferred for use as a columellar strut.…”

Modified technique to increase nostril cross-sectional area after using rib and septal cartilage graft over alar nasal cartilages

“…Another difference pertains to the process by which the costal cartilage graft is carved: Gunter et al 5 One of the problems during rhinoplasty for those who prefer a structural approach may be the small amount of usable cartilage available. During septoplasty, the surgeon can face an inadequate amount and quality of graft; e.g., sometimes there is more ethmoid and vomer than septal cartilage, which makes it more difficult to carve an appropriate graft.…”

“…Among them, Using an open approach of rhinoplasty, Gunter et al 4,5 proposed a lateral crural strut graft measuring 3 to 4 mm wide and 18 to 25mm long, to support the lateral wall and the pyriform aperture lobe under lateral crura. Also, Toriumi 6,7 proposed a similar type of graft, as described by Gunter et al 4,5 , differing mostly in its position, which could be located over the lateral crura except in cases where the nasal skin is extremely thin. In our study, we chose to insert the grafts above de lateral crura because some cadavers had a very friable nasal mucosa and during our pilot study a few dissections lead to mucosal perforation.…”

“…While there are many techniques that the modern plastic surgeon can perform during a nasal surgery, there remains a significant gap concerning the external nasal valve [1][2][3][4][5][6][7][8][9][10][11][12][13] .…”