The Diced Cartilage Glue Graft for Radix Augmentation in Rhinoplasty

Once Upon a Rhinoplasty: The History of the “Queen” of Facial Plastic Surgery

“…[139][140][141][142][143][144] Solid rib, with a variety of sculpting and wiring techniques introduced to minimize warping, was challenged with a variety of techniques featuring diced cartilage wrapped in temporalis fascia or stabilized with fibrin glue. [145][146][147][148][149][150] The arguments continue to this day as to which technique is superior and often depend on the experience of the practitioner who selected a specific technique. Excellent results are being achieved with numerous variations of both techniques, with experience playing a large role in outcomes.…”

“…151 An important concept related to dorsal reduction and augmentation has also evolved since the 1990s-the use of radix grafts. 149,152 It has become increasingly apparent that overreduction of large noses, especially those with thick skin, can lead to a small but amorphous nose. Surgeons began to augment the radix with cartilage and soft tissue to lessen the need for dorsal reduction and retain more overall definition.…”

Replacement of the Nasal Dorsum with a Diced Cartilage Glue Graft

“…The graft has been described elsewhere and its use has been expanded to segmental augmentations of the dorsum. 12,13 The technique includes a hump resection in one piece after incision of the cartilaginous part with a number 15 scalpel blade and the bony part with a Rubin osteotome. The vestibular mucoperichondrial and mucoperiosteal lining are preserved by dissecting the mucosa off the undersurface of the fornix with a Cottle Elevator.…”

Dorsal Augmentation-Diced Cartilage Techniques: The Diced Cartilage Glue Graft

“…2,12 A modified technique based on bonding of diced cartilage by sequentially applying the two components of commercially available fibrin glue has been presented and evaluated by the author of this article. [46][47][48][49] The rationale behind this modification was an attempt to simplify the laborious preparation of a DCF graft, improve the versatility, especially for partial dorsal augmentation, and create an anatomical shape. Fibrin as a scaffold for cartilage tissue engineering received substantial attention in the recent years with reports commenting favorably on chondrocyte viability in different fibrin-based carriers both in vitro and in vivo.…”

“…This combination is felt to be particularly advantageous in patients with a delicate narrow middle third and thin skin. 49 Follow-uphas shown that the DCG radix grafts almost invariably become firmly attached to the periosteum of the radix, presumably due to residual fibrin glue activity on its dorsal surface. Complaints of floating radix grafts that are perceived as a foreign Fig.…”