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Published on: June 20, 2018
Semi-Dried PRP-Stabilized Diced Cartilage: A Novel Technique for Stable and Moldable Dorsal Nasal Augmentation in
Alper Yenigun1, Ramazan Bahadir Kucuk2, Huseyin Balikci3
1Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvari, 34093, Fatih, Istanbul, Turkey.
Background:
Diced cartilage is widely used for dorsal nasal augmentation, but its fluid consistency may predispose to migration, contour irregularity, and handling difficulties. We describe a preliminary technical feasibility experience using autologous platelet-rich plasma (PRP) combined with diced cartilage and semi-dried with controlled warm airflow to create a cohesive, moldable graft for dorsal and radix augmentation.
Technique:
Septal cartilage was diced into 0.5-1-mm fragments and mixed dropwise with liquid PRP prepared using the Silfradent MEDIFUGE CGF system. The mixture was spread on a sterile surface and exposed to controlled warm airflow for 3-5 minutes, with the graft surface temperature maintained at or below 45 °C, until a semi-solid consistency was achieved. The resulting graft was inserted into the dorsal and radix pocket without fascia wrapping, sutures, or fibrin adhesives.
Results:
The technique was applied in two primary rhinoplasty cases and one revision rhinoplasty case. All three patients were evaluated clinically and photographically at 1 month and 6 months postoperatively. During the observed short- to mid-term follow-up, the graft demonstrated satisfactory intraoperative handling and clinically maintained dorsal contour, with no clinically evident migration, infection, contour irregularity, or overlying skin thinning. This clinical maintenance of dorsal contour was observed in both primary and revision cases, including patients with thin and very thick skin. These findings are based on clinical examination and standardized photographic assessment only.
Conclusions:
Semi-dried PRP-stabilized diced cartilage may represent a simple, low-cost, and foreign-material-free option for dorsal augmentation in selected patients. In this preliminary technical feasibility series, the technique provided cohesive intraoperative handling and clinically satisfactory short- to mid-term contour maintenance without wrapping or adhesive fixation. Long-term stability, volume preservation, and biological effects remain unproven and require objective validation.
Level Of Evidence Iv:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
