Three-Dimensional Cartilage Graft Technique: A Different Management for Nasal Tip Surgery

Nasal tip reconstruction is an important component in aesthetic rhinoplasty. Different congenital deformities or acquired disorders (trauma, infection, operations) may affect the nasal tip structure. Additionally, the natural appearance of the nasal tip projection can be lost after rhinoplasty. The lower lateral cartilages are the main structural component of the nasal alae and tip support. Any distortion or failure on the alar cartilages may lead to both functional and aesthetic problems. In this article, the author presents a different method for nasal tip support.

Between 2010 and 2014, a chart review was performed of 64 consecutive primary rhinoplasty patients (29 women, 35 men). Postoperative follow-up period was at least 12 months. None of the patients were secondary patients or no nasal tip surgery was done previously. The patients with secondary rhinoplasty, saddle deformity, revision rhinoplasty, cleft lip nose, and crooked nose were excluded from the study.

The three-dimensional pyramid cartilage technique was used in all the patients with the open rhinoplasty approach to ensure the nasal tip projection. Average time was between 4 and 7 minutes for graft harvesting and suturing to the nasal tip in this technique. The follow-up period was between 12 and 48 months. There was a revision procedure in 4 patients because of the distortion of the tip graft and tearing of the graft material. The revision procedure was done for these patients.

In this article, the author presents "three-dimensional pyramid cartilage technique' as a new and alternative technique for better projection of the nasal tip. This technique also provided the support to nasal tip using only 1 graft material with minimal manipulation, with no donor area morbidity or another cartilage resection except the nasal septum.