The bilateral conchal cartilage graft: a new technique in augmentation rhinoplasty

The most common procedures to reconstruct a severe saddle-nose deformity are autogenous costal cartilage, iliac bone grafting, or Silastic implants. Each of them has its specific disadvantages. As an alternative solution, an autogenous bilateral conchal graft in sandwich technique is described. A 3-layer graft for the dorsum and a 2-layer graft to support the depressed columellar -tip area grants a more natural and elastic reconstruction of the nasal framework. The conchal grafts are taken by an incision made on the preauricular surface of the ear. How to plan the curved grafts by meticulous "cross-hatching" and to immobilize them in the recipient area by transcutaneous suturing is demonstrated.