Current Practices in Dorsal Augmentation Rhinoplasty

Abstract

orsal augmentation rhinoplasty is used to address the aesthetic and functional impairments caused by a deficient nasal dorsum. Augmentation rhinoplasty can be performed using a variety of different surgical techniques and grafting materials that all have distinct advantages and disadvantages. The surgeon should be familiar with these various options and be able to select the option most appropriate for each patient.In patients with a deficient dorsum, augmentation rhinoplasty may be indicated to restore proper form and function. 1,2 Although dorsal augmentation is a relatively common procedure, it remains a topic of great controversy among plastic surgeons. Today, a multitude of different surgical techniques and graft materials are used in augmentation rhinoplasty, with each option having distinct advantages and disadvantages. 3,4 No one surgical approach or augmentation material is best in every scenario, and the plastic surgeon should be well-versed in all options to create the best surgical plan possible for each patient. This article reviews the current state of augmentation rhinoplasty, including a detailed discussion of the various materials that are currently available for use in dorsal augmentation. INDICATIONSIn all patients, a thorough preoperative nasal analysis should be performed to assess nasal aesthetics and develop a surgical plan. It is also important to provide patients with realistic expectations before surgery to avoid poor patient satis-Great Neck, N.Y.

An Innovative Stent Consisting of Expanded Polytetrafluoroethylene and Ear Cartilage in Rhinoplasty For Asians: Application I of Dai’s Exogenous Extension Stent Concept

“…3,4 Artificial implant materials usually include silicone and expanded polytetrafluoroethylene. 5,6 The grafts of current stents usually extend from the caudal end of the septum cartilage and depend on the force of the septum, which we named the endogenous extension stent. 3 The endogenous extension stents are especially suitable for patients with high nasal dorsum and good septum cartilage development, with a wide range of indications such as long nose, short nose, and nasal tip refinement.…”

A Canadian Experience With Off-the-Shelf, Aseptically Processed, Costal Cartilage Segment Allografts in Complex Rhinoplasty

“…Alloplastic implants are useful in practice because they offer prefabrication methods, minimal absorption, no donor-site morbidity, and precise carving. 6 However, the incidence of infection and implant extrusion is a significant disadvantage. 6 , 13 , 16 Septal cartilage grafts are versatile and convenient to harvest, suited for both onlay and structural grafts; 12 , 16 , 17 however, their limited supply may be insufficient for complex primary and secondary rhinoplasties, as well as reconstructive posttraumatic cases.…”

“… 6 However, the incidence of infection and implant extrusion is a significant disadvantage. 6 , 13 , 16 Septal cartilage grafts are versatile and convenient to harvest, suited for both onlay and structural grafts; 12 , 16 , 17 however, their limited supply may be insufficient for complex primary and secondary rhinoplasties, as well as reconstructive posttraumatic cases. 12 , 17 Harvesting cartilage from the ear is the next best approach considering that the donor site lies in the same surgical field and leaves an inconspicuous scar; 13 however, the cartilage's intrinsic curvature and structural frailty limit its use for specific types of grafts used to provide rigid structural support such as columellar strut grafts.…”

“…To avoid donor-site morbidity and mitigate the risks of postoperative complications, fresh frozen, aseptically processed, and nonterminally sterilized costal cartilage segment allografts (CCSAs) have emerged, which are readily available, and have demonstrated safety and efficacy in several studies. 2 , 5 , 6 This study reports the early experience of a single surgeon performing complex primary and secondary rhinoplasty procedures using fresh frozen, aseptically processed, and nonterminally sterilized CCSAs, in Canada.…”

Genetically engineered chondrocytes overexpressing elastin improve cell retention and chondrogenesis in a three‐dimensional GelMA culture system

“…Elastic cartilage tissue engineering is critical for restoring and maintaining tissue or organ structure and function, particularly for head and neck structure repair (Fisher et al, 2022; Otto et al, 2015). Elastic cartilage is distinguished from other types of cartilage by its abundance of elastic fibers and high elasticity, which mainly exist in the ear, nose, larynx, and epiglottis (Bos et al, 2018; Kaňa et al, 2019; Nimeskern et al, 2014, 2016; Novoselov et al, 2016).…”