[Cartilaginous graft in rhinoplasty]

Area of Science:

• Plastic Surgery
• Otolaryngology
• Biomaterials Science

Background:

• Cartilage grafts are integral to both primary and secondary rhinoplasty procedures.
• Graft fixation can be optimized with open approaches, though closed approaches are also feasible.
• Understanding donor site characteristics is crucial for successful rhinoplasty outcomes.

Purpose of the Study:

• To comprehensively review various cartilage donor sites used in rhinoplasty.
• To delineate the advantages, disadvantages, harvesting techniques, and indications for each donor site.
• To guide surgeons in selecting the most appropriate cartilage graft material.

Main Methods:

• Review of established surgical techniques for cartilage harvesting from septum, ear, and ribs.
• Analysis of graft characteristics including pliability, thickness, and support.
• Evaluation of specific applications for different graft types, such as tip, alar, and dorsal onlay grafts.

Main Results:

• Septal cartilage is often ideal but may be insufficient, particularly in revision cases.
• Conchal cartilage offers pliability suitable for tip and alar reconstruction.
• Rib cartilage provides stiffness for robust support, while diced cartilage wrapped in fascia (DCF) is effective for dorsal augmentation, mitigating common complications.

Conclusions:

• The choice of cartilage donor site in rhinoplasty depends on graft requirements and patient anatomy.
• Septal, conchal, and rib cartilage each possess unique properties making them suitable for distinct reconstructive challenges.
• Diced cartilage wrapped in fascia presents a valuable alternative for dorsal augmentation, improving aesthetic results and reducing risks.