Cartilage grafts for the nasal tip

Control over nasal tip projection is essential in rhinoplasty. Nasal projection is defined as the length of the perpendicular drawn from the anterior facial plane to the tip-defining point. The nasal lobule shield-type graft, made of autologous cartilage, is one of the most important methods to maintain projection. The graft may also control length, (counter)rotation of the nose and refinement of the tip. The external approach facilitates in-situ suturing and sculpting of the graft. Between 1989 and 1991, 300 patients underwent an external rhinoplasty. In 94 (31%) an autologous graft for the nasal tip was used. The aesthetic result was pleasing to the vast majority of the patients. Nasal tip rigidity resolved in all patients within one year post-operatively. One patient needed revision surgery, because of graft resorption.