An algorithm for deciding alternative grafting materials used in secondary rhinoplasty

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 59; no. 4; pp. 409 - 416
• Main Authors: Acarturk, Sabri, Arslan, Emrah, Demirkan, Ferit, Unal, Sakir
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.01.2006; Elsevier
• Subjects: Adult; Algorithms; Biological and medical sciences; Bone Transplantation - methods; Cartilage - transplantation; Decision Making; Female; Grafting materials; Humans; Male; Medical sciences; Nose - abnormalities; Nose - surgery; Polyethylene - therapeutic use; Reoperation; Rhinoplasty - methods; Secondary rhinoplasty; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Transplantation, Autologous; Secondary rhinoplasty; Grafting materials; Human; Reoperation; Stomatology; Algorithm; Plasty; Treatment; Surgery; Nose; Graft; Biomaterial; Rhinoplasty
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2005.05.023

Severe middle vault deformity with disturbed nasal form and function is one of the most challenging procedures to correct in a secondary rhinoplasty. Reconstructing the deformity with autologous septal cartilage would be the primary choice of most surgeons, if it were always available. However in certain cases the lack of a sufficient quantity of autologous cartilage has forced surgeons to explore other viable options. This paper discusses our experience with the combined use of spreader and dorsal onlay grafts from various materials in the reconstruction of severe middle vault deformity in 110 patients. In follow up, (between 6 and 42 months; mean 21 months) all patients were noted to have improved in both aesthetics and function with no major complications noted. In summary, this study proposes that any engrafting material can be used safely when the proper surgical principals and technique are employed.