Augmentation rhinoplasty with rib cartilage graft

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To investigate the outcome and complications of augmentation rhinoplasty with rib cartilage grafts.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Retrospective study<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Subjects:</strong> Patients who underwent dorsal nasal augmentation with autologous rib cartilage grafts between June 2008 and October 2012.<br /><strong>RESULTS:</strong> A total of 12 patients (3 male, 9 female) were included in the study. Mean age was 29 years. Seven were cases of primary simple rhinoplasty with four cases of revision (previously using alloplastic materials) and one case of trauma. Indications for the procedure were all cosmetic. There was no incidence of infection, both in the donor and recipient sites, warping of the graft, graft extrusion, resorption, pneumothorax, chest wall deformity or prolonged edema. Post-operative pain in the donor site was relieved by oral pain medications. No revision surgery was required.<br /><strong>CONCLUSION:</strong> Costal cartilage is a good option for structural support of the nose. In our experience patients have become wary of the complication of allografts and have opted to use autografts. The surgeon's knowledge of the nasal anatomy as well as his or her experience with autologous grafts plays a major role in avoiding post-operative morbidity.</p>

The sail excision technique: A modified alar lift procedure for Southeast Asians noses

p style=text-align: justify;strongOBJECTIVE:/strong To describe a new sail shaped excision technique for alar lift surgery and present the outcome of this technique through photo documentation. br /br /strongMETHODS:/strongbr /strongDesign:/strong Surgical Innovation; Case series br /strongSetting:/strong Tertiary Government Hospital br /strongParticipants:/strong Four patients underwent alar rim lift procedure using sail excision technique performed by the senior co-author. The indication for sail excision technique was a hanging ala (type IV) based on the classification of alar-columellar discrepancies by Gunter emet al/em. The outcomes were described with comparison of pre-operative and post-operative photographs.br /br /strongRESULTS:/strong Post-operative improvement of the alar-columellar relationship and counter-rotation of the tip, the gull's wing in flight was further enhanced. There were no scar contracture or vestibular stenosis, and scars were aesthetically acceptable.br /br /strongCONCLUSION: /strongAlar lift surgery demands an accurate diagnosis and analysis of the alar-columellar discrepancies. In Southeast Asian noses, unlike Caucasian noses, the most common indication for alar surgery are wide and overhanging ala. Our proposed technique is an easy and safe method of correcting alar overhang. This procedure with its advantages represents a new, reliable and simple way of achieving predictable results in many rhinoplasty cases./p