Approaches & Techniques
Cartilage Grafting Technique
Cartilage grafting techniques in rhinoplasty involve the use of tissue grafts - to support, augment, or reshape the nasal structure. These techniques are crucial for achieving stable and natural-looking results, especially in cases of complex nasal deformities, revision surgeries, or when additional support is needed.
Autologous Tissue Graft
This refers to using the patient's own cartilage or bone grafts in many cases to minimise the risk of rejection or complications associated with synthetic/foreign materials. A tissue from one part of the body is used to augment or reconstruct the nose. Common sources of autologous tissue grafts used in rhinoplasty include:
Septal Cartilage
Septal Cartilage is harvested from the patient's own nasal septum. It is ideal due to its strength, flexibility, and compatibility with the nasal framework. It is used to augment the nasal bridge, support nasal tip projection, or straighten the septum in septoplasty.
Ear Cartilage
Ear Cartilage is harvested from the patient's ear, typically the conchal bowl. Ear cartilage is plentiful and can be carved into various shapes to fit specific contours. It is used when septal cartilage is insufficient or compromised. This is commonly used for nasal tip refinement, dorsal augmentation, or to reconstruct nasal framework in revision rhinoplasty.
Rib Cartilage
Rib Cartilage harvested from the patient's rib cage and is used to reconstruct or augment the nasal structure. Rib cartilage is strong and provides significant structural support, suitable for complex reconstructions. It is used in cases of severe nasal deformities, revision rhinoplasty, or when larger amounts of graft material are required. It is also ideal for augmenting the nasal bridge in cases of flat nasal dorsum or insufficient nasal projection. Some patients prefer rib cartilage to avoid any synthetic materials, fearing that using them might invalidate their health insurance coverage for rhinoplasty. However, cartilage can occasionally shrink and deform over time.
Rib cartilage is abundant and offers robust support and volume, making it suitable for reconstructive purposes where septal or ear cartilage may not suffice. They also offer long-term stability and durability.
Alloplastic (Synthetic) Grafts
Synthetic grafts could be made of various synthetic materials such as silicone, expanded polytetrafluoroethylene (ePTFE), or hydroxyapatite. Synthetic grafts are durable and do not resorb over time. They are used in augmentation rhinoplasty to build up nasal dorsum or reshape nasal tip. Their benefits include providing predictable results and not requiring any donor tissue. However, there may be risk of complications such as infection or extrusion.
