Reconstruction of the Nasolabial Area by Composite Graft From the Concha

Converse, John Marquis

doi:10.1097/00006534-195003000-00004

Cited by 27 publications

(3 citation statements)

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“…Converse 173 shows good results in reconstructing the nasolabial area by a com¬ posite graft from the concha. This method permitted immediate replacement of tissue (Fig.…”

Section: Malignant Growthsmentioning

confidence: 99%

Plastic Surgery During the Years 1949 and 1950

La¹,

Jc²,

Fa³

1951

Archives of Otolaryngology - Head and Neck Surgery

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“…Converse 173 shows good results in reconstructing the nasolabial area by a com¬ posite graft from the concha. This method permitted immediate replacement of tissue (Fig.…”

Section: Malignant Growthsmentioning

confidence: 99%

Plastic Surgery During the Years 1949 and 1950

La¹,

Jc²,

Fa³

1951

Archives of Otolaryngology - Head and Neck Surgery

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“…[ 1 ] Despite a modern history spanning over a century, composite grafts continue to be an enigma for many surgeons. Pessimism expressed through publications by Joseph[ 2 ] and Limberg[ 3 ] over high failure rates, discouraged the surgeons of that time, till other successful reports[ 4 5 6 7 8 9 10 ] established the procedure. Since then there have been more articles describing enhanced graft survival by cooling,[ 11 ] on bettering the aesthetic outcomes by appropriating the donor site of the composite graft,[ 12 13 ] and on management of the ear as a donor site.…”

Section: Introductionmentioning

confidence: 99%

Securing aesthetic outcomes for composite grafts to alar margin and columellar defects: A long term experience

Ahuja

Chatterjee

Shrivastava

2014

Indian J Plast Surg

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Introduction:Composite grafts for nasal reconstruction have been around for over a century but the opinion on its virtues and failings keeps vacillating with a huge difference on the safe size of the graft for transfer. Alar margin and columellar defects are more distinct than dorsal nasal defects in greater difficulty in ensuring a good aesthetic outcome. We report our series of 19 consecutive patients in whom a composite graft was used to reconstruct a defect of alar margin (8 patients), alar base (7 patients) or columella (4 patients).Patients and Methods:Patient ages ranged from 3-35 years with 5 males and 14 females. The grafts to alar margin and base ranged 0.6-1 cm in width, while grafts to columella were 0.7-1.2 cm. The maximum dimension of the graft in this series was 0.9 mm x 10 mm. Composite grafts were sculpted to be two layered (skin + cartilage), three layered wedges (skin + cartilage + skin) or their combination (two layered in a portion and three layered in another portion). All grafts were cooled in postoperative period for three days by applying an indigenous ice pack of surgical glove. The follow up ranged from 3-9 months with an average of 4.5 months.Results:All of our 19 composite grafts survived completely but they all shrank by a small percentage of their bulk. Eleven patients rated the outcome between 90-95% improvement. We noticed that composite grafts tended to show varied pigmentation in our patients, akin to split skin grafts.Conclusion:In our opinion, most critical to graft survival is its size and the ratio of the marginal raw area to the graft bulk. We recommend that graft width should not exceed 1 cm to ensure complete survival even though larger sized grafts have been reported to survive. We recommend cooling of the graft and justify it on the analogy of ‘warm ischemia time’ for a replantation, especially in warmer climes like ours in India. We have outlined several considerations in the technique, with an analysis of differing opinions that should facilitate a surgeon in making an informed choice.

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“…When dealing with reconstructions of alar cartilage defects, the plastic surgeon should focus on two important issues: the reconstructive choice between flaps and grafts and the specific technique to use. The reconstruction of alar cartilage defect is normally executed taking into consideration three parameters: patient's age, occurrence of preexisting scars (i.e., traumas, burns, previous surgery) and size of the defect 2 . General rules usually indicate the use of flaps in older patients (for their tissue laxity that prevents cosmetic problems of retraction) and cartilage grafts in younger patients.…”

mentioning

confidence: 99%