Use of Auricular Composite Graft in Rib Cartilage-Based Rhinoplasty for Contracted Nose Correction

BACKGROUND

This study investigated the effects of combining an auricular composite graft with rib cartilage-based rhinoplasty to correct contracted noses in Asian patients with a history of multiple previous operations.

METHODS

A total of 43 patients were included in the retrospective analysis of secondary rhinoplasty procedures. The surgical approach involved short-nose correction, using rib cartilage for septal extension grafts and chondrocutaneous composite grafts harvested from the conchal part of the ear for internal nasal lining reconstruction. The authors' assessment encompassed clinical outcomes, the occurrence of complications; and the use of 3-dimensional photography for nasal measurements at the preoperative, 3-month, and 1-year postoperative stages.

RESULTS

With regard to graft survival, 12 patients (27.9%) showed greater than 80% graft engraftment, 29 patients (67.4%) showed 50% to 80% graft engraftment, and 2 patients (4.6%) showed 20% to 50% graft engraftment. Two of these patients required wound irrigation for infection control and additional repair and were finally discharged without significant nasal deformity. At 3 months postoperatively, 3-dimensional anthropometry showed significant differences in nasal dorsum length (4.46 ± 1.79 mm), nasal height (1.25 ± 1.25 mm), nasal tip projection (4.06 ± 1.76 mm), and columellar-labial angle (22.75 ± 14.19 degrees). No significant relapse of nasal parameters was noted 1 year postoperatively.

CONCLUSIONS

Auricular composite graft combined with rib cartilage-based rhinoplasty enables the comprehensive restoration of nasal structures, addressing the inner, intermediate, and outer layers. This approach can serve as an effective and sustainable option for correcting contracted noses in Asian patients who have undergone multiple operations.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, IV.

Correction of the Nasal Ala

None.

In-office Endonasal Minor Revision Rhinoplasty

The revision rhinoplasty presents many unique challenges to the facial plastic surgeon. While many cases will require a full revision in the operating room, there are several isolated deformities which may be repaired in the office via an endonasal approach. This provides many benefits to the patient and surgeon including decreased cost, shorter recovery time, avoidance of general anesthesia, and less discomfort. It is critical to identify defects appropriate for endonasal repair, establish clear expectations with the patient, and work within one's skill set and level of experience. The surgeon who can comfortably navigate both open and endonasal techniques can offer their patients a comprehensive set of solutions for revision rhinoplasty. In this article we outline the defects amenable to this type of repair as well as technical considerations for each defect addressed. We hope it serves as a useful framework for the range of deformities the rhinoplasty surgeon may take on for in-office repair.