Clean-Cut Smoothing of the Visible Cartilage Grafts by Sanding With a Scalpel

The visibility of cartilage grafts underneath the skin is a complication of rhinoplasty particularly in patients with thin nasal skin. Preparing the graft with optimum dimensions, symmetry, and smoothness is crucial for the fine crafting of the cartilage to prevent visibility. The camouflage of the visible cartilage graft with a crushed cartilage, a resected cephalic portion of the lower lateral cartilage, fascia, connective and/or fatty tissues is another option for hiding the visibility. The nasal tip is the most common location where the graft visibility is of concern.The authors introduce the smoothing of the cartilage graft by sanding it with a scalpel. This technique safely provides perfection and precision of smoothing of the cartilage in very desired shape. It is possible to obtain 3D super clean-cut shining surface.The tangential sculpting of the cartilage graft with a scalpel carries the risk of over resection. However, the sanding with a scalpel moves forward so gentle that over resection is not possible.It is also possible to smooth non-visible structural grafts such as strut and spreader grafts to reduce surface irregularities.Additionally, the sand-dust caused by cartilage sanding is a 'cartilage pâté' which can be used for camouflage of minute irregularities of the nasal dorsum.