Diced cartilage under perichondrial carpet with reinforcement (DCUP) technique for nasal dorsal augmentation

Abstract

Background: Correction of the secondary cleft lip nasal deformity is a real challenge for the esthetic surgeons. Grafts are an integral part of modern rhinoplasty with costal cartilage being increasingly used in the secondary case. The use of costal cartilage is fraught with problems like visibility and warping. Introduction: We propose an innovative alternative technique, Diced Cartilage Under perichondrial carpet with reinforcement (DCUP) technique keeping in mind, the Indian noses which usually do not support the liquid (filler) or semisolid (diced cartilage in fascia [DCF]) augmentation due to thick skin and weak structural support. Aims and Objective: To introduce a technique which can provide both a softer and natural looking dorsum and a strong framework to withstand the stress of healing forces in early postoperative period. Materials and Methods: Over the past 3 years we have used this technique in 25 patients with primary as well as secondary rhinoplasties including posttraumatic and secondary cleft lip nose deformity. Postoperative follow-up was done with clinical examination and photography. Results: In our study, a total of 25 patients were operated, there were 9 males and 16 females, giving a male:female ratio of about 1:2. Mean follow-up was 18 months. All patients had rounded, well contoured, and smooth dorsum. There was no incidence of fracture, warping, visibility or extrusion of graft, or palpable or visible sutures. Conclusion: Proposed technique of Diced Cartilage Under Perichondrial carpet with reinforcement (DCUP) technique is a very good alternative especially in Indian setting to keep the good effects of DCF that is, smoother, softer, and natural looking dorsum and also able to withstand postoperative contracting forces owing to its stable base of costal cartilage graft.