Costal cartilage grafting for dorsal augmentation

Abstract

The aesthetic and functional implications of an appropriate dorsal contour are immense and contribute significantly to the overall rhinoplasty results. The authors discuss anatomy of the upper, middle, and lower thirds of the nose, goals for augmentation, materials used for dorsal augmentation, evaluation of the patient, harvesting the grafts, determining the needs of the dorsum with contour deformity, contour deformity with middle nasal vault collapse, contour deformities with significant loss of structural support, and defects encompassing the bony dorsum. Augmentation and reconstruction of the nasal dorsum is a challenging component of rhinoplasty. The role of the middle nasal vault in function and aesthetics is vital, and maintenance of the support mechanisms is paramount to the ideal dorsal profile. The interplay between the nasal pyramid, cartilaginous septum and upper lateral cartilages, and lower third of the nose must be taken into consideration during reconstruction.