Radix Grafting to Maintain Dorsal Height

Abstract

Over the past 25 years, the trend for rhinoplasty has been toward higher dorsums. This emphasis on the more aesthetically prominent nose has led to examination of augmenting the radix to achieve this higher dorsum. Traditionally, augmentation of the radix has been limited to those cases where the radix is disproportionately low. While it is true that augmentation due to low radix disproportion is the major criterion for radix grafts, radix augmentation may benefit many patients who do not fit into that category. It is well known that the dorsum will rise after lateral osteotomies and nasal bone infracture. Without reduction this can create a hump. Integrity of the dorsal projection achieved with the infracture can be maintained by implementation of the radix graft procedure which overcomes the appearance of a dorsal hump. A retrospective review of 52 patients who underwent radix grafting was performed. Some were augmented due to low radix disproportion and some were augmented to maintain the aesthetic line of the higher dorsal projection. This review examined the following criteria: type of cartilage graft used; cartilage morselization; cartilage tiering, complications; and, revisions of radix graft implants. This study examines the use of radix grafting in those instances where a high profile cannot be otherwise achieved. A broader utility of radix grafting is encouraged to maintain dorsal height in aesthetic rhinoplasty.