EFFECTIVENESS OF AUTOLOGOUS COSTAL CARTILAGE GRAFT IN AUGMENTATION RHINOPLASTY

Muayed Mejthab,Jabir Hameed

doi:10.33762/bsurg.2019.164516

Abstract

Rhinoplasty is the most demanding aesthetic procedure that is currently shifted from ablative to conservative surgical procedures, one of these procedures is using cartilage grafts for correction and augmentation of congenital and acquired nasal deformities. The Autologous costal cartilage graft (ACCG) is a good choice for reconstruction of these deformities because its ample amount and good strength. The aim of this study is to assess the outcome of using autologous costal cartilage graft in augmentation rhinoplasty in severe congenital and acquired nasal deformities. This is a prospective study of 10 patients aged between 16-45 years (7 females and 3 males) in form of 4 cases of saddle nose, 3 cases of cleft lip nasal deformity, two cases of post-traumatic severely deviated nose, and one case of African nose. Patients underwent augmentation rhinoplasty by ACCG, from July 2018-June 2019. The follow-up period was 6-12 months concentrating on preoperative and postoperative structural and functional evaluation. The outcome of augmentation rhinoplasty by ACCG was evaluated by 2 independent surgeons and the results were accepted by both surgeons and patients in 9 out of 10 cases (apart from one case that she had infection of the graft) with donor site complication rates near to the related studies. In conclusion, ACCG is one of the best choices for severe nasal deformities that need ample amount of cartilage for structural and functional support and good aesthetic outcome with low complication rate. Keywords: Autologus graft, Costal cartilage, Surgery, Rhinoplasty, Augmentation.

Highlights

Rhinoplasty is considered the most demanding procedure in plasticSociety of Plastic Surgeons (ASPS), over 350,000 rhinoplasties were performed in surgery
We used costal cartilage graft as onlay lateral crural graft, and one patients who had traumatic nasal deviation with nasal breathing difficulty was managed by spreader graft as shown in table III
In the era of recent rhinoplasty, the nasal augmentation for those patients rhinoplastic surgeon is often in need of whomever had saddle, short and broad ample amount of cartilage graft material nose. All of these techniques were done for a variety of uses such as nasal dorsal for achieving the desirable aesthetic and augmentation, nasal septal reconstruction functional results with a stable, a smooth and for nasal tip surgery

Summary

Introduction

Rhinoplasty is considered the most demanding procedure in plasticSociety of Plastic Surgeons (ASPS), over 350,000 rhinoplasties were performed in surgery. Cartilage sparing suture techniques and augmentation of the deficient areas to correct contour deformities and restore structural support are commonly employed[3]. Because cartilage is a normal component of the native nasal structure, it is logical to use it to replace deficiencies and create structure, contour, and aesthetic enhancement. Thin grafts are useful when minimal visibility is desired as in areas of thin skin over the nasal dorsum or in revision cases. Nasal augmentation has many specific uses in aesthetic rhinoplasty. These include correction of disproportionately low radix, insufficient dorsal nasal profile, inadequate projection of the nasal tip, alar collapse, and columellar recession. Asians, and mestizo noses each have own particular configuration; corrective nasal surgery should be performed bearing in mind the natural facial aesthetics of patient’s race. Cartilage graft in aesthetic rhinoplasty is the rule rather than exception in secondary rhinoplasty and cleft lip rhinoplasty[5]

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