Use of Diced Conchal Cartilage with Perichondrial Attachment in Rhinoplasty.

[BACKGROUND] The conchal cartilage is favored in nasal tip surgery, but is limited in dorsal augmentation. The authors evaluated diced conchal cartilage with perichondrial attachment in augmentation of the nasal dorsum, radix, and/or tip.

[METHODS] The medical records of 37 patients who underwent rhinoplasty using diced conchal cartilage with perichondrial attachment as an augmentation material for the nasal dorsum, radix, or tip, at a tertiary academic institution, were reviewed retrospectively. Postoperative surgical outcomes were assessed by comparing facial photographs before and after surgery. In addition, complications were analyzed.

[RESULTS] Diced conchal cartilage with perichondrial attachment was used alone in 22 patients (59.5 percent) and in combination with autologous cartilage graft, homologous fascia lata, or expanded polytetrafluoroethylene in 15 patients (40.5 percent). Successful outcomes were achieved in 33 patients (89.2 percent). Dorsal augmentation with diced conchal cartilage with perichondrial attachment was performed in 30 patients (81.1 percent) and radix augmentation in nine patients (24.3 percent), and their dorsal and radix heights, respectively, were significantly increased after surgery (p < 0.01 each). Four patients (10.8 percent) who underwent tip surgery with diced conchal cartilage with perichondrial attachment showed successful aesthetic outcomes, although anthropometrically measured tip projection and rotation were not significantly affected (p > 0.05). Complications included hematoma and keloid at the conchal cartilage donor site, and poor aesthetic outcome in four patients (10.8 percent).

[CONCLUSION] Diced conchal cartilage with perichondrial attachment may be a valuable graft material with which to augment the nasal dorsum, radix, and/or tip in rhinoplasty.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Therapeutic, IV.