Hump Resection Research Articles

An Aesthetic Dorsum: The CATS Graft

Reconstruction of the dorsum following a Joseph hump removal can be accomplished with a properly thinned septal graft. This will camouflage the residual twists in the dorsal septum, the irregularities at the osseocartilaginous function, and an open roof. It is particularly useful in those patients with a prominent hump but can be used in those patients with narrow noses in whom one does not wish to do an infracture following the hump resection.

Reconstruction of the nasal cap with a thin septal graft.

Following hump resection, dorsal irregularities are common. Patients with thin skin or those whose skin will become thin will develop the stigmata of rhinoplasty due to an open roof, irregular osseous cartilaginous junction, or twisted septum becoming visible. Although other techniques have been described to overcome this problem, they have significant drawbacks. We describe a technique for dorsal camouflage using a thin septal graft. The technique has the advantages of providing dependable camouflage with autogenous tissue without raising the dorsum and without the need for a separate donor site. It involves sanding a 35 x 7 mm shield-shaped dorsal graft to less than 3/4-mm thickness and placing this over the nasal dorsum to simulate the preoperative fused dorsal cap. We have performed this technique in 18 patients followed for 28 months. We utilize this graft in all patients with twisted noses and all thin-skinned individuals. It is not a technique of dorsal augmentation but rather of camouflage.

Relationship between the protrusion of the nasal tip and the dorsum in rhinoplasty.

The author discusses the relationship of the nasal tip and its protrusion to the physical contours of the dorsum. This relationship can be positive or negative. He emphasizes the necessity of correcting the tip before any correction of the dorsum, believing that correction of the alar cartilages is the key that determines the amount of hump resection or of lowering of the nasal dorsum, demonstrating his concepts with appropriate case illustrations. The author's technique (1974) of forward projection of the lower nasal base with a transverse silicone implant for patients with a negative tip-dorsum relationship is described.