gms | German Medical Science

In functional-aesthetic rhinoplasty, a change of surgical philosophy can be observed. While traditionally most rhinoplastic operations were dominated by tissue resection, more and more surgeons stress the importance of restructuring and stabilizing the nose by cartilage grafts and suture techniques. This development in rhinosurgery arises from long term experience showing that insufficient stabilization of nasal structures can lead to sequelae such as nasal valve collapse, even decades after surgery. Modern rhinosurgery pursues the goal of long term results, which are functionally and aesthetically durable over decades. Cartilage grafts play a key role in this effort.

The author presents five of the most commonly used stabilizing cartilage grafts, namely spreader grafts (cartilage strips positioned between upper lateral cartilage and septum roof), lateral crus grafts (cartilage strip on the lower lateral cartilage), alar batten grafts (cartilage grafts in the area of the nasal valves), columellar strut (cartilage strip in the columella), and septal extension graft (cartilage plate between anterior septum and columella). Depending on availability and purpose, the cartilage can be harvested from the septum, the auricle or the rib. Indications, surgical techniques and results are illustrated in the talk.