Outcomes of dorsal nasal augmentation using costochondral graft.

Objective: To assess functional and aesthetic outcomes in patients having undergone dorsal nasal augmentation with costochondral graft in a tertiary care setting. METHODS: The single-centre, retrospective, observational study was conducted at Shifa International Hospital, Islamabad, Pakistan, and comprised data of patients who underwent dorsal nasal augmentation using costochondral graft between January 1, 2018, and December 31, 2022. Aesthetic outcomes in terms of patient satisfaction were assessed using Facial Appearance, Health-related Quality of Life and Adverse Effects scores. Data was analysed using SPSS 26. RESULTS: Of the 46 patients, 28(61%) were males and 18(39%) were females. The overall mean age was 28.39±9.13 years. Dorsal nasal deficiency occurred secondary to congenital causes in 12(26.1%) patients, trauma 19(41.3%) and prior surgery 15(32.6%). Postoperative complication rate was 7(15%); 3(6.5%) had recipient site infection and 2(4.3%) had rib graft resorption. Besides, 1(2.2%) patient reported pain 2 months postoperatively and 1(2.2%) had hypertrophic scarring. Patient satisfaction with the outcome was noted in all the 10 parameters analysed. Most commonly reported problem was that the nose was 'looking thick/swollen' by 12(26.1%) patients, but the issue resolved during 1-year follow-up. Conclusion: Costochondral graft was found to be an ideal material for dorsal nasal augmentation, with high patient satisfaction rate.

Nasal filling guided by high frequency ultrasound: Reducing risks.

BACKGROUND: Given the significant increase in the quantity of cosmetic procedures utilizing hyaluronic acid fillers, including in the nasal region, the initial evaluation of patients using high frequency ultrasound becomes a crucial instrument in evaluating and handling nonsurgical rhinoplasty. AIMS: The aim of this article is to introduce an assessment methodology for nasal filling guided by high frequency ultrasound. PATIENTS/METHODS: A prospective and single-center study was conducted with 12 Latin American patients. The patients underwent nasal filling with hyaluronic acid following high power ultrasound mapping. RESULTS AND CONCLUSIONS: In the evaluation of the GAIS scale, all patients reported improvement with the treatment. No infections, nodules, ischemia, or other relevant adverse effects were noted. Real-time ultrasound-guided filler techniques have been developed to reduce the risk of vascular compromise, confirming the distribution pattern of blood vessels. It's also crucial to visualize the cannula at the same moment as the vessels, even if the previous vascular mapping was performed. Therefore, the utilization of high frequency ultrasound can act as a pivotal tool in augmenting procedure safety.

Süreyya-Dani technique, a new technique to address notching of soft triangle and opening external nasal valve.

Introduction: While different methods are employed for fixing narrowed nasal valves and preventing the notching of soft triangles, this study aims to demonstrate the effectiveness of a new technique called Süreyya-Dani Technique. Methods: This prospective study composed 100 patients who underwent rhinoplasty using the Süreyya-Dani technique. All patients presented with either notching of the soft triangle and/or external nasal valve dysfunction. Patients with the absence of soft triangle notching and external nasal valve dysfunction were excluded from this study. Facial analysis was conducted for all patients to identify any asymmetry in the face, and all nasal defects were identified. Descriptive statistics were calculated for different variables. Analytical statistics, namely Chi-Square test, was conducted with a significance level set at P < 0.05. Results: In the current study, 100 patients were involved, out of which 63 (63%) were female and 37 (37%) were male. The participants' ages ranged from 18 to 46 years, with a mean age of 30 years. various chief complaints were found among patients, with the majority 37(37%) expressing cosmetic concerns. A statistically significant difference was found for the association of nasal tip defects with genders, intraoperative findings, and chef complaints, and the association between the degree of external valve insufficiency and crural weakness (P-value < 0.05). Conclusion: Despite many techniques that have been put forward to fix narrowed nasal valves and prevent notching of the soft triangle, the Süreyya-Dani Technique could work to prevent its occurrence successfully.

A narrative-style review of non-surgical rhinoplasty: Indications, outcomes, and limitations.

The aim of this narrative-style review was to evaluate non-surgical rhinoplasty in terms of indications, outcomes, and limitations. Both 'PubMed' and 'Science Direct' were reviewed by all authors, in order to reach consensus with regard to the chosen studies. Studies published from 1980 to 2023 were searched using the key terms "non-surgical rhinoplasty", "dermal filler", "thread lifting", and "botulinum toxin", and relevant papers were selected. Non-surgical rhinoplasty refers to the use of injectable temporary fillers to augment selected areas of the nose, in order to achieve improved appearance or function in select patients. It includes the use of dermal fillers, thread lifting, and botulinum toxin injections. The perfect dermal filler would be inexpensive, safe, painless to inject, hypoallergenic, and long lasting. In addition, it should produce consistent and predictable results, feel natural under the skin, take little time to inject, be ready to use, exert no downtime on the patient, and have a low risk of complications. Regions of the nose treated with filler injections include the frontonasal angle, dorsum, nasolabial angle, and columella. Thread lifting and botulinum toxin injection are the other methods of non-surgical rhinoplasty. Dermal fillers, thread lifting, and botulinum toxin injections can be used as non-surgical rhinoplasty. Dermal fillers and botulinum neurotoxin can be used alongside each other to allow minimally invasive resculpting of the nasal region and midface, compensating for a reduction in tissue volume and the formation of rhytides.

Nonsurgical Rhinoplasty: An Updated Systematic Review of Technique, Outcomes, Complications, and Its Treatments.

BACKGROUND: For patients looking for temporary results or who do not want surgery, nonsurgical rhinoplasty using filler injections has become increasingly popular. Filler materials and surgical techniques have improved in recent years, but serious complications remain. Therefore, the aim of this systematic review is to summarize the common types of fillers and injection techniques, complications, and treatment to help clinicians perform in a safer and more effective way. METHODS: A systematic review was performed using keywords and Medical Subject Headings search terms. PubMed, Embase, and the Cochrane Library were searched using the appropriate search terms. Data collected from each study included injection materials, location, technique, patient satisfaction and complications, and treatment. RESULTS: From the 1812 studies identified, 30 were included in the systematic review. A total of 9657 patients underwent nonsurgical rhinoplasty, most commonly with hyaluronic acid (HA) (96.76%), followed by calcium hydroxyapatite (CaHA) (1.22%). Overall satisfaction was 99.08%. The overall incidence of complications was 39.11%, with the highest incidence of erythema and swelling (27.95%). Most of the complications are mild, but there are still 0.27% of the patients who have undergone severe complication-an arterial occlusion. CONCLUSIONS: Nonsurgical rhinoplasty is an effective and relatively safe option for improving the profile of the nose, with a short operative time and high patient satisfaction. Most of the complications were mild, but still serious vascular complications such as blindness, skin necrosis, and stroke were as high as 0.27%. A thorough understanding of the anatomy of the nasal vessels and a precise surgical technique is an important basis for prevention. A BULLET POINT LIST: (1) We summarize the common types of fillers and injection techniques, complications, and treatment of complications to guide physicians to perform nonsurgical rhinoplasty in a safer and more effective manner. (2) Out of 1812 studies through the search strategy, 30 articles were included in the systematic review. A total of 9657 patients underwent nonsurgical rhinoplasty. (3) Nonsurgical rhinoplasty is an effective and relatively safe option to improve the profile of the nose, with a short surgical time and high patient satisfaction. (4) Most of the complications were mild, but some severe complications due to the vascular factors such as blindness, skin necrosis, and cerebral infarction need to be vigilant. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Rapid Production Nasal Osteotomy Simulators With Multi-Modality Manufacturing: 3D Printing, Casting, and Molding.

OBJECTIVE: To expand and improve upon previously described nasal osteotomy models with the goals of decreasing cost and production time while ensuring model fidelity. To assess change in participant confidence in their understanding of and ability to perform nasal osteotomies following completion of the simulation course. STUDY DESIGN: Prospective study. SETTING: Simulation training course for otolaryngology residents at West Virginia University. METHODS: A combined methodology of 3D printing, silicone molding, and resin casting was used to design a nasal osteotomy model to address material issues such as print delamination. Multiple models were then used in a simulation lab on performing nasal osteotomies. Model utility and impact on participant confidence was assessed at baseline, postlecture, and postsimulation lab. RESULTS: Using a combined manufacturing methodology, we achieved a production time reduction of 97.71% and a cost reduction of 82.02% for this polyurethane resin nasal osteotomy model relative to a previously described osteotomy model. Participants in the simulation course were noted to have a significant improvement in confidence in their understanding of and ability to perform nasal osteotomies from baseline and postlecture and also from postlecture and postsimulation lab (P < .05 for all). CONCLUSION: By incorporating multiple manufacturing modalities (molding and casting) in addition to 3D printing, this study achieved a large reduction in both production time and cost in fabrication of a nasal osteotomy simulator and addressed material limitations imposed by fused deposition modeling printers. This design methodology serves as an example on how these barriers may be addressed in unrelated simulation projects. Model fidelity was improved with addition of a silicone soft tissue midface. Improvement in participant confidence was noted following completion of the simulation lab.

Asian Male Blepharoplasty and Rhinoplasty.

The authors present the contemporary landscape for males seeking Asian blepharoplasty and Asian rhinoplasty, with special emphasis on the unique anatomical and aesthetic considerations for this patient population. The authors highlight the latest techniques used to achieve superlative results.

Contemporary Male Rhinoplasty Surgery.

In general, fewer male patients seek rhinoplasty surgery than females. The surgical principles are similar in both populations with some special anatomic considerations that will need attention. There is a higher rate of body dysmorphic syndrome in males seeking rhinoplasty as well as greater challenges with patient satisfaction, and the consultation process needs to be thorough and deliberate when undertaking aesthetic surgery in this population to maximize positive outcomes.

Impact of Tissue Handling and Size Modification on Septal Chondrocyte Viability.

INTRODUCTION: The physical modification of cartilage grafts during rhinoplasty risks chondrocyte death at the margins where the tissue is cut. This study compares chondrocyte viability between diced, scaled, and pate samples in human models, and further computes percent chondrocyte viability as a function of sequential dicing size in a computational model. METHODS: Septal cartilage from 11 individuals was prepared as follows: diced (1 mm cubic), scaled (shaved to <1 mm thickness ~ translucent), pate (0.02 g of scraped cartilage surface), positive control (2 × 2 mm diced), and negative control (2 × 2 mm diced soaked in 70% EtOH). Viability analysis was performed using Live/Dead assay™ and confocal microscopy. Numerical simulation of cartilage dicing in 0.05 mm increments was performed using MATLAB assuming 250 chondrocytes/mm3 with each average chondrocyte size of 65 µm2. RESULTS: Chondrocyte viability was similar between 1 mm diced cartilage, scaled cartilage, and positive control samples (p > 0.05). Conversely, pate samples had significantly less viability compared to positive controls, diced samples, and scaled samples (all p < 0.01 after Bonferroni correction). Pate samples had similar chondrocyte viability compared to negative controls (p = 0.36). On computational modeling, cartilage viability decreased to 50% as the diced sample was cut from 1 mm edge length to 0.7-0.8 mm. Similarly, cartilage viability decreased to 26% at 0.55-0.65 mm, 11% at 0.4-0.5 mm, and <5% at <0.4 mm edge length. CONCLUSION: Modifying septal cartilage grafts into 1 mm diced or scaled samples maintains ideal chondrocyte viability whereas pate preparations result in significant chondrocyte death. According to computational analysis, chondrocyte viability sharply decreases as the cartilage is diced below 0.7-0.8 mm. LEVEL OF EVIDENCE: N/A Laryngoscope, 2024.

Awareness and Interest in Rhinoplasty and Its Postoperative Complications Among Females in the Northern Border Region, Saudi Arabia.

BACKGROUND: Rhinoplasty is a popular cosmetic surgical procedure that aims to reshape the nose, enhance its appearance, and improve nasal function. This study investigated the awareness, attitudes, and interest in rhinoplasty among females in the Northern Border Region of Saudi Arabia, as well as their knowledge of potential postoperative complications. METHODS: An online survey was used to perform a cross-sectional study. Female participants aged between 18 and 45 years, living in the Northern Border Region of Saudi Arabia, were selected. The questionnaire consisted of three main sections: personal information, attitude toward rhinoplasty, and complications of rhinoplasty. RESULTS: 905 females participated in our study. The majority (87.8%, n=795) had heard about rhinoplasty before, and 54.9% (n=497) knew someone who had undergone the surgery. Social media was the most common source of information about rhinoplasty (67.2%, n=608). A significant proportion of participants (72.4%, n=655) believed that their nose appearance sometimes or always limited their social and professional activities. However, only 16.7% (n=151) expressed a desire to change or improve their nose appearance through surgery. The educational status of the participant (*p*=0.027) and their father (*p*=0.011) were significantly associated with interest in rhinoplasty. Satisfaction with nose appearance, breathing, and family and friends' opinions about the participant's nose were also significantly associated with interest in rhinoplasty (*p*<0.001 for all). The majority of participants (88.4%, n=800) were aware of at least one complication, with the most recognized complications being breath disorders (74.6%, n=675), headache (70.6%, n=639), and mismatch of their new noses with the rest of their faces (69.8%, n=632). Age (*p*=0.008), city of residence (*p*<0.001), and satisfaction of family and friends with the participant's nose (*p*=0.019) were significantly associated with complication awareness. CONCLUSION: This study found that women in Saudi Arabia's Northern Border Region had a high level of awareness and interest in rhinoplasty, despite concerns regarding the safety, availability of educational resources, and ethical considerations in promoting the procedure. The findings highlight the need for accurate and comprehensive information about rhinoplasty and its potential complications to be readily available to the public, particularly through targeted educational interventions and responsible advertising regulations.

Mechanically fragmented cartilage grafts in rhinoplasty: An up-to-date systematic review.

INTRODUCTION: Grafts play key roles in functional and aesthetic rhinoplasty. Autologous grafts are generally preferred for their biocompatibility and less visibility when used in a fragmented fashion. The aim of this study was to review mechanically fragmented cartilage grafts techniques described in the literature, outlining indications, outcomes, and complications. MATERIAL AND METHODS: A systematic review of articles published from 1999 until December 2022 was conducted, using the following key words: "rhinoplasty," "cartilage," and "graft." Studies were selected according to the inclusion and exclusion criteria, and data were extracted and grouped for subgroup analysis. Rates of partial resorption, total resorption, surgical revision, and major and minor complications were statistically analyzed. RESULTS: Thirty eligible studies were included. Three cartilage fragmentation methods were identified: diced, shaved, and crushed. Cartilage grafts were further divided into injectable and noninjectable grafts. Diced cartilage was the most commonly used. Dorsal irregularities were the main indication. Overall, 1.68% of patients experienced partial resorption, 0.27% experienced total resorption, and 1.46% needed revision. The partial resorption rate in the diced group was significantly lower than that in the shaved group. Injectable grafts showed a higher rate of partial resorption. The revision rate was higher with noninjectable grafts. CONCLUSION: The partial resorption rate was lower in patients treated with diced cartilage. Injectable grafts are malleable and suitable for the correction of minimal irregularities, although they are affected by a higher rate of partial resorption. Wrapping materials may be used when significant augmentation is required.

The Use of Cross-Linked Hyaluronic Acid in Non-surgical Rhinoplasty Using Italian Technique.

INTRODUCTION: Projection and upper rotation to the tip is fundamental in the nasal rejuvenation, as a matter of fact the tip is the most important and has strongly effects on the improve appearance and quality of life. The aim of the present study was to evaluate reshaping the tip of the nose by cross-linked hyaluronic acid using Italian technique. METHODS: In a period between November 2019 and 2023, a total of one hundred and forty healthy, 95 females and 45 man patients, were performed with a mean age 44±5 (age range: 31-52 years old) affected by tip of congenital (22) or ageing nose hypotonia (118), and reduced volume that need of an elevation of the nose tip. The anatomic markers have been considered for the anthropometric measurements after the filler rhinoplasty. Two infiltrations were performed, one in the infiltration into the antero-caudal access over the columella produce upward rotation of the tip of the nose and second infiltration into the antero-superior access produce the projection of the tip of the nose. Medical device used in the study was Neofound STRUCT LIDO (LOVE COSMEDICAL srls-Via Toniolo 9, 57022 Castagneto Carducci, ITALY) containing sodium hyaluronate/hyaluronic acid high molecular weight (1.500

Comparison of the efficacy of fat, cartilage, and bone grafts in traumatic and asymmetric noses.

BACKGROUND: Correction of asymmetry and irregularity deformities with autologous grafts, without osteotomies, offers advantages to both plastic surgeons and patients with severe deviation. Various autologous tissues such as fat, bone, and cartilage grafts are viable options for this purpose. OBJECTIVES: This study aimed to compare the efficacy of 3 autologous filling materials in patients with bone asymmetry. METHODS: A retrospective evaluation was conducted on 297 patients seeking aesthetic nose surgery between 2015 and 2022. Only primary patients without prior surgery and those with bone asymmetry from trauma, with dorsum protrusion <3 mm, and without osteotomy were included. Patients were divided into fat, cartilage, and bone groups. Grafts were applied to the concave side during closed rhinoplasty, and evaluations were done 12 months after surgery by blinded plastic surgeons and patients using established assessment tools. RESULTS: Fat, cartilage, and bone grafts were utilized in 74, 127, and 96 patients, respectively, with a mean follow-up of 19 months. The mean graft volumes were 1.0 cc (bone), 1.3 cc (cartilage), and 1.6 cc (fat). The patient self-assessment scores were 75%, 84.9%, and 86.6%, respectively. The Asher-McDade averages were 77.2%, 86.7%, and 88.4%, respectively. Cartilage and bone graft results were statistically similar in patients' self-evaluation and significantly higher than those of fat grafts. Blinded assessments showed no significant difference between the cartilage and bone groups. CONCLUSION: Placing autologous grafts on the concave side for patients with minimal nasal bone protrusion (<3 mm) yields successful results. Cartilage grafts offer advantages in volume, result estimation, and preparation time, making them suitable for larger patient cohorts.

Surgical complications in combined rhinoplasty and endoscopic sinus surgery.

KEY POINTS: Complications in combined surgery are equivalent to ESS but are higher than rhinoplasty alone. The most common complications are pneumonia, stroke, and epistaxis. Rhinoplasty surgeries with graft use have a higher risk of complications.

Current Treatment Progress of Unilateral Cleft Lip Nasal Deformities.

INTRODUCTION: Secondary nasal deformity following unilateral cleft lip is a common facial congenital malformation. Due to its complex treatment, there is currently no unified treatment plan in clinical practice. Dysplasia of cartilage, dislocation of muscles, and dysplasia of maxilla are the main causes of secondary nasal deformities of unilateral cleft lip. This article provides a comprehensive summary of the perioperative period and treatment process of unilateral cleft lip nasal deformities, aiming to find better clinical treatment guidance for patients with unilateral cleft lip and nasal deformity. METHODS: A review of numerous previous studies on unilateral cleft lip nasal deformity, particularly within the last five years, was conducted to gather information on treatment strategies and perioperative care for unilateral cleft lip rhinoplasty. CONCLUSION: Currently, there is still no unified final surgical method for the correction and treatment of unilateral cleft lip nasal deformity. In terms of surgical timing, simultaneous primary rhinoplasty and lip repair are gradually being recognized internationally, while intermediate rhinoplasty can be considered when it affects the patients social and psychological life. Patients with severe initial nasal deformity require multiple revisions. Secondary rhinoplasty remains the ideal treatment for final correction of secondary nasal deformities in unilateral cleft lip. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Hybrid Chin Advancement: Combining Fat and Sliced Cartilage Grafts for Chin Augmentation During Rhinoplasty.

BACKGROUND: Facial balance significantly impacts aesthetics, particularly in the middle and lower thirds. Patients with chin retrusion often benefit from sagittal plane chin advancement in rhinoplasty, enhancing surgical outcomes and satisfaction. OBJECTIVES: This article presents a method for analyzing chin deformities and discusses a hybrid treatment approach to harmonize facial features, complementing rhinoplasty. METHODS: The chin positions of patients treated by the senior author were assessed. A retrospective analysis included 49 patients with chin retrusion of 2.5-6 mm. Among them, 22 patients initially offered chin implants declined, leading to planned chin augmentation. Fat grafting was exclusively performed for 20 patients lacking sufficient cartilage. The "Hybrid Chin Advancement" technique involved supporting tissues beneath muscles with nasal septum cartilage and fat injections and tissues above muscles with fat injection alone. RESULTS: Pre- and postoperative Legan angle measurements and chin advancements were compared across three groups. While preoperative Legan angles were statistically similar, postoperative Legan angles and advancement changes were significantly higher in the implant group (p < 0.0001). Comparing hybrid chin advancement and fat grafting groups, postoperative Legan angles and advancement changes were significantly higher in the hybrid chin group (p < 0.0001). CONCLUSIONS: Fat grafting suffices for mild advancements (~ 2 mm), while the hybrid chin method is effective for moderate advancements (~ 4 mm). For advancements exceeding 6 mm, implants or osseous genioplasty are optimal. Our study's hybrid approach offers an easy, safe, and reliable method for achieving facial harmony in the lower two-thirds without compromising patient expectations. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Reconstructive Septorhinoplasty for Surgical Correction of Tessier's No. 0 Cleft in Adult Patients.

BACKGROUND: Tessier No. 0 cleft, characterized by a bifid nose, significantly impacts facial development, imposing significant psychological and financial burdens on patients. Correction lacks consensus due to varied presentations and limited documentation of surgical treatments, notably in adults. SOLUTION: Loco-regional soft tissue flaps can address minor deformities, but establishing a robust skeletal framework is often crucial for permanent correction. INNOVATION: This article introduces a novel and effective approach through reconstructive septorhinoplasty for addressing this anomaly.

Assessment of Nasal Aesthetic Parameters in Patients with Unilateral Cleft Lip and Palate - A Retrospective Study.

OBJECTIVES: To assess and compare the deviating nasal cephalometric parameters of patients with unilateral cleft lip and palate (UCLP) with a control group. The study also aims to correlate the deviating cephalometric parameters with two aesthetic scoring systems. DESIGN: A retrospective study. SETTING: Dental college and hospital. PARTICIPANTS: Pre-treatment lateral cephalograms and extra oral photographs of 20 adult patients with repaired UCLP presenting for orthodontic treatment. 20 patients with age and type of malocclusion matched control were selected. MAIN OUTCOME: The nasal cephalometric parameters of patients with UCLP and a control group were compared. The nasolabial region of patients with cleft lip and palate (CLP) was scored using Asher McDade Aesthetic Index (AMAI) and Cleft Aesthetic Rating Scale (CARS). The scoring was done by six different groups assessors to study their perception of the nasolabial region. Correlation between cephalometric parameters and the aesthetic scores was done. RESULTS: The study found significant differences in nasal length (P = .003) and depth (P < .001) between UCLP and the non-cleft control group. In the aesthetic assessment, orthodontist gave the least scores, while layman group scored the highest. The CARS nose aesthetic scores showed statistically significant high, negative correlation with the nasal length (P = .01). CONCLUSION: The cephalometric parameters and the aesthetic indices can be aid the orthodontists in the assessment of nasolabial aesthetics and additionally refer for further definitive rhinoplasty to improve the patient's overall facial aesthetics.

Percepção tátil e visual no aumento de radix com cartilagem fragmentada livre na rinoplastia / Tactile and visual perception in radix augmentation with free fragmented cartilage in rhinoplasty

Introdução: A correção da relação radix dorso nasal é realizada há vários anos utilizando as mais variadas técnicas como enxerto de cartilagem auricular, septal ou costal, preenchimento com ácido hialurônico, uso de fáscia e enxertos e uso de cartilagem picada em cubo, silicone e ácido hialurônico. O uso de cartilagem fragmentada é descrito na literatura e tem ganhado adeptos nos últimos anos, pela facilidade em ser realizado. O objetivo neste estudo é descrever nossa experiência com a utilização do enxerto de cartilagem fragmentado no aumento do radix comparando a percepção visual e tátil do paciente e sua satisfação. Método: Estudo observacional em pacientes submetidos a rinoplastia no período de janeiro 2018 a junho de 2022, em cirurgias nas quais ocorreu o aumento de radix com o uso de enxerto de cartilagem picada. Resultados: Dos 47 pacientes, a maioria era do sexo feminino (35, 74,4%), com média de idade de 34,6 anos (18-44). Quanto ao tipo de pele, Fitzpatrick tipo 3 (n=28, 59,5%) foi o principal, sendo encontrado frequentemente pacientes com pele de média espessura (n=23, 48,9%). Complicações presentes foram infecção (1 caso), migração de cartilagem picada (3 casos), e reabsorção parcial (1 caso). Na avaliação da percepção tátil 42 pacientes (89,3%) percebiam, à palpação, as proeminências cartilaginosas e na visual apenas 2 (4%). A satisfação foi elevada em 45 (96%) pacientes. Conclusão: A cartilagem picada livre pode ser utilizada na região do radix com resultados satisfatórios.

Introduction: Correction of the nasal radix dorsum relationship has been carried out for several years using the most varied techniques such as auricular, septal, or costal cartilage grafts, filling with hyaluronic acid, use of fascia and grafts and the use of diced cartilage, silicone, and hyaluronic acid. The use of fragmented cartilage is described in the literature and has gained popularity in recent years, due to its ease of use. The objective of this study is to describe our experience with the use of fragmented cartilage graft in radix augmentation, comparing the patient's visual and tactile perception and satisfaction. Method: Observational study in patients undergoing rhinoplasty from January 2018 to June 2022, in surgeries in which the radix was increased with the use of minced cartilage graft. Results: Of the 47 patients, the majority were female (35, 74.4%), with a mean age of 34.6 years (18-44). As for skin type, Fitzpatrick type 3 (n=28, 59.5%) was the main one, with patients with medium-thickness skin being frequently found (n=23, 48.9%). Complications present were infection (1 case), migration of chopped cartilage (3 cases), and partial resorption (1 case). In the assessment of tactile perception, 42 patients (89.3%) perceived cartilaginous prominences on palpation and only 2 (4%) visually. Satisfaction was high in 45 (96%) patients. Conclusion: Free minced cartilage can be used in the radix region with satisfactory results.