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Objective:To investigate the postoperative effect of paranasal concavity augment by block united with diced autologous costal cartilage.Methods:The data of 76 patients who were underwent costal cartilage rhinoplasty together with paranasal augmentation from January 2016 to December 2019 were analyzed retrospectively. The surgical technique was described in detail. Medical charts and operative records were reviewed to summary the complications. Patients′subjective satisfaction of the postoperative nasal appearance was self-evaluated with grading (1 worse, 2 no change, 3 improved, and 4 much improved). Cosmetic effects were evaluated by the measurements of the nasolabial angle and the distance between ACJ and intertragic notch preoperatively and postoperatively.Results:The postoperative follow-up duration was 6 to 34 months. Overall, functional and aesthetic outcome was satisfactory in most patients, and the mean score by the patients′self-evaluation was 3.4±0.5. Graft exposure, mobility, or significant resorption, pneumothorax or significant donor-site pain were not observed. The average nasolabial angle was changed from (78.2±13.2)° preoperatively to (89.8±10.2)° 6 months postoperative at the last follow-up ( t=152.00, P<0.01). And the distance from the alar-cheek junction to the left tragus was increased by 3.8±2.1 (2.2-6.1) mm. Conclusions:Costal cartilage rhinoplasty combined with augmentation of parasal area can improve parasal depression, with stable postoperative effect and fewer postoperative complications, and has a good effect for patients with normal occlusal relationship or mild abnormality.
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Objective:To explore the effect of two different treatment methods of dorsum implants using autologous costal cartilage, accordion technique (AT) and multilayer oppositional suture technique (MOST), in preventing complications such as distortion and warping of the grafts.Methods:From January 2016 to December 2019, 119 patients underwent rhinoplasty with autologous costal cartilage as the dorsum implant. The dorsum implants were processed by two different techniuqes. Medical charts and operative records were reviewed to summary the complications, especially warping. Patients′ subjective satisfaction and doctors′ objective measurement of the postoperative nasal appearance were evaluated with a grading system.Results:The postoperative follow-up duration was 6 to 28 months. Graft exposure, mobility, or significant resorption, pneumothorax or significant donor-site pain were not observed. The warping rate was higher in the AT (7.8%, 6/77) than in the MOST (2.4%, 1/42) group, although not significantly. Overall, there were no differences in overall patient functional and aesthetic satisfaction between the two groups.Conclusions:Multilayered oppositional suture technique for the autologous costal cartilage grafting may minimize the complication of graft warping and might be an effective alternative for nasal dorsal augmentation, particularly in Asian patients.
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Objective To present our experience and techniques with the use of autologous costal cartilage grafts in Asian rhinoplasty,and to report the surgical results and complications in 86 consecutive rhinoplasty cases.Methods All operations were performed by the first author (Liu AT) with open approach,costal cartilages and perichondrium were used to reconstruct the nasal tip projection according to the tripod theory in rhinoplasty,after removing the previous injection material,L-shaped implant or hypertrophic scar tissue in the tip.Medical charts and operative records were reviewed retrospectively to summary the complications.Nasal dorsum augmentation was done by costal cartilage or I-shaped allograft,sometimes with anterior sheath of rectus abdominis.Patients' subjective satisfaction of the postoperative nasal appearance was self-evaluated with grading (1 worse,2 no change,3 improved,and 4 much improved).Results From September 2015 to March 2017,86 patients underwent rhinoplasty at our hospital.The postoperative follow-up duration was 6 to 20 months.Overall,functional and aesthetic outcome was satisfactory in most patients,and the mean score by the patients' self-evaluation was 3.3 ± 0.6.Graft exposure,mobility,or significant resorption,pneumothorax or significant donor-site pain were not observed.Conclusions Even with minimal complications and morbidities,autologous costal cartilage grafts in Asian rhinoplasty is a versatile and reliable graft material for nasal tip surgery in severe short or saddle nose,contracted nose due to previous L-shaped augmentation and revision rhinoplasty in which the septal cartilage has already been harvested.
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Objective: To investigate the technical points and effectiveness of autogenous costal cartilage transplantation in repair of Binder's syndrome. Methods: Between June 2012 and June 2017, 8 cases of Binder's syndrome were admitted. There were 3 males and 5 females, aged 16-31 years (mean, 22 years). All patients were conformed to the typical manifestations of Binder's syndrome. The autogenous costal cartilage was harvested and carved into the nasal dorsum graft, nasal column graft, and nasal basement graft. Before and after operation, standard pictures of the anterior view, lateral view, and base view were taken to measure facial related parameters of nasal dorsum length, nasal columella-lobule ratio, nasofrontal angle, nasal columella-upper lip angle, nasal tip projection rate, and nasion projection. Then the effectiveness of this surgical procedure for Binder's syndrome was evaluated. Results: All incisions healed by first intention without acute infections. All patients were followed up 6-36 months, with an average of 18 months. The foreign body sensation in upper lip and scar hyperplasia in thoracic incision occurred in 1 case, respectively. The nasal morphology improved significantly and the coordinated relationships of the nose with the upper lip and face were restored postoperatively. Postoperative parameter measurements were taken in 6 cases. The nasal dorsum length, nasal columella-lobule ratio, nasofrontal angle, nasal columella-upper lip angle, nasal tip projection rate, and nasion projection at preoperation were significantly improved when compared with the values at 6 months after operation ( P0.05). Conclusion: Autogenous costal cartilage transplantation in repair of Binder's syndrome can obviously improve patients' appearance of the external nose and middle face, and obtain the persistent effectiveness.
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Objective To explore the comprehensive approach of rhinoplasty using autologous costal cartilage and e-PTFE,and to observe the outcome and possible complications.Methods A 3-4 cm long costal cartilage was taken out mostly from the 6th or 7th rib and then divided into several parts and shapes.Structural reconstruction of the nasal tip was then done with these costal cartilage parts.Radix augmentation was conducted with e-PTFE.Results From Jan.2013 to Sept.2014,48 patients were treated with this method,all females,aged 22-35 years.36 of them had received rhinoplasty before,12 of them received none.Satisfying aesthetic contouring of the nasal tip and dorsum had been achieved in 45 patients.Deviation of the collumella and nostril asymmetry were found in 3 patients.Among all patients,no such complications as pneumothorax,hemothorax,infection,or hemotoma were observed.The scar on the donor site was not obvious.Conclusions Costal cartilage is sufficient,supportive and easily shapable,when applied to the structural reconstruction of the nasal tip,which can meet the demands of patients who prefer more outstanding and delicate nasal tip contouring.
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Objective To summarize and explore the clinical effect of auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap.Methods The procedure involved three stages.The first stage was the delay procedure of postauricular skin flap.The second stage was the auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap about 3 weeks after the delay procedure.The third stage involved construction of tragus and conchal cavity and other local correction 6 months or longer after the second stage surgery.The clinical effect,patients' satisfaction and complication were observed.Results This method was used in 28 patients,31 ears of congenital microtia.23 cases completed auricular reconstruction with three stages,the other 8 cases completed only two stages.All auricular reconstruction were successful.The location,size and shape of reconstructive ears were good.The complications were few.The patients or their relatives were basically satisfactory.Conclusions Auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap is a safe and effective method.