[Resorption of cartilage grafts in rhinoplasty: fundamental basis]

Resorption of the autologous cartilage graft of the nasal dorsum is a problem which concerns all rhinoplasticians. Their rate of resorption is estimated between 20 to 30% of the graft volume and can occur with no means of prevention from the side of the surgeon. The goal of this article is to highlight, through a short review of the literature, the current data regarding the composition of the septal cartilage, its healing process and the progress made in cartilaginous tissue engineering to adapt our surgical technique. Cartilaginous tissue engineering does not yet have the abilities to provide a replacement septal cartilage with the same molecular composition, the same mechanical properties and devoid of volume loss after implantation and in spite of a certain progress, autologous cartilage grafts are still making the headlines. However to avoid the resorption of the latter and to preserve their volume, it seems necessary to avoid crushing them so as not to compromise chondrocyte viability and proliferation. Cutting-out millimeter-length dices seems more adapted to preserve cellular viability but remains insufficient because of the low healing capacities of the cartilage. Diced-cartilage wrapped with connective tissue seems an elegant and efficient solution over the long run to safeguard their volume and to harmonize contours and irregularities of the dorsum.