gms | German Medical Science

Background: In literature there is a lack of a single cartilage graft to address problems in projection, rotation and/or definition in mestizo patients that takes into account the characteristics of this population in terms of alar cartilage structure, length and shape.

Objective: To describe the novel technique and evaluate the aesthetic outcomes of the combined auricular graft in mestizo patients undergoing primary rhinoplasty.

Methods: A retrospective cohort study of consecutive patients who underwent primary rhinoplasty using the combined auricular graft between January 2015 and June 2017 was performed. The minimum duration of follow-up was 6 months. Main outcomes were nasal tip projection and tip rotation angle.

Results: Among the 61 patients (38 women [62.2%] and 23 men [37.8%], mean age 29.3 ± 10.8 years) the mean differences in projection were statistically significant between T0 and T1, T0 and T2, and T0 and T3 (1.63, 1.39, and 1.32mm, respectively). Thus, 80.9% of the increase in projection that had been achieved at T1 was maintained at T3 (p < 0.001). The relapse ratio measured 19.1% (mean difference T1-T3, 0.31 ± 0.10mm). The mean tip rotation angle at T0 (111.69 ± 3.59°) significantly increased by 2.37 ± 3.13° (T3, 114.06 ± 2.50°, p < 0.001).

Conclusions: One single auricular cartilage graft can significantly improve projection and/or rotation by simultaneously addressing structure, length and shape of lower lateral cartilages. Misbalance between the medial and lateral crura is avoided and retraction risks are prevented. Consequently, a more natural, precise and accurate tip position is obtained.