Nasal Dorsum Management Using Fragmented Cartilage Grafts

Thinness of nasal dorsum skin and subcutaneous tissue underlying nasal dorsal skin are the major factors related to the visibility of small irregularities. Here, the authors discuss the use of bare fragmented cartilage grafts in managing nasal dorsum and the results obtained.Eight hundred fifty-six patients were operated for rhinoplasty between September 2009 and September 2014. Fragmented cartilage grafting over the nasal dorsum was performed in 781 of 856 patients. In total, 214 patients who were followed up regularly were evaluated. Nasal dorsum management of 182 out of 214 patients was performed as is described here and is included in this study. The authors fragmented the cartilage grafts with Kocher clamp until the fragmented cartilages do not exhibit resistance, which are then placed over the nasal dorsum and can be shaped easily by external manouevers.Follow-up period ranged from 6 to 36 months. There was no seroma formation, infection, or abscess formation during the postoperative follow-up period. Four patients required a secondary operation for nasal dorsum management. The irregularity was corrected by simple rasping. The rest of the patients were satisfied with their nasal dorsum appearance. Nasal dorsum management with fragmented crushed cartilages showed durable results during the follow-up period.The authors use fragmented cartilage grafts in nasal dorsum management and do not wrap them into endogenous or exogenous sleeve material thus preventing the delay for vascularization of cartilage grafts, which is directly related to obtain durable results. By this way, durable results and smooth nasal dorsum can be maintained.