Use of irradiated cartilage in rhinoplasty of the non-Caucasian nose

Abstract

Background Aesthetic correction of the non-Caucasian nose may require a high volume of graft material to achieve an aesthetically pleasing shape and contour while maintaining characteristics in keeping with the patient's ethnicity. Objective We report our experience with the long-term use of irradiated homograft costal cartilage (IHCC) in 17 non-Caucasian patients. Methods Individually packaged specimens of IHCC were obtained from government-approved tissue banks for intraoperative use in the augmentation of the dorsum as an onlay graft and, when necessary, to create maxillary-columellar-tip (MCT) struts and crural and spreader grafts. A V-shaped cut was made at the base of the MCT graft to accommodate the anterior maxillary ridge. The dorsal-only cartilage grafts were sutured to the underlying periosteum and framework to prevent tipping or shifting of the cartilage. Small tip grafts were not used, and defatting of the tip skin was avoided. Results Patients were monitored for periods ranging from 7 months to 14 years. No immediate complications were noted, and only 1 late complication (>30 days after surgery) occurred; it involved the shifting of a dorsal graft that had not been sutured. Patient satisfaction was excellent. Conclusions The use of IHCC for augmentation rhinoplasty of the non-Caucasian nose saves operative time, eliminates both the need to harvest cartilage and the morbidity that can result from this procedure, and provides excellent, long-lasting aesthetic results with few complications.