Facial Plast Surg 2012; 28(04): 417-426
DOI: 10.1055/s-0032-1319840
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Secondary Rhinoplasty: Management of the Overresected Dorsum

Rollin K. Daniel
1   Private Practice, Newport Beach, California
,
Ali Sajadian
1   Private Practice, Newport Beach, California
› Author Affiliations
Further Information

Publication History

Publication Date:
07 August 2012 (online)

Abstract

Any discussion of grafting the dorsum in secondary rhinoplasty must take into account the different indications (aesthetic, augmentation, and structure) as well as recent changes in materials and techniques (fascia, diced cartilage). We have placed solid dorsal grafts with diced cartilage grafts either as an isolated diced cartilage graft in fascia graft or as the aesthetic dorsal contour layer of a composite reconstruction. The rational for this profound change in selection and indication of dorsal grafts for revising the overresected dorsum will become clear as the various alternative materials and techniques are analyzed. Currently, we only employ autogenous tissues.

 
  • References

  • 1 Daniel RK. Mastering Rhinoplasty. New York, NY: Springer; 2009
  • 2 Daniel RK. Rhinoplasty: An Atlas of Surgical Techniques. New York, NY: Springer; 2002
  • 3 Daniel RK. Aesthetic Plastic Surgery: Rhinoplasty. Boston, MA: Little, Brown; 1993
  • 4 Sheen JH, Sheen AP. Aesthetic Rhinoplasty. 2nd ed. St. Louis, MO: Mosby; 1987
  • 5 Converse JM. Corrective and reconstructive surgery of the nose. In: Converse JM, ed. Reconstructive Plastic Surgery. Philadelphia, PA: Saunders; 1977
  • 6 Daniel RK. Secondary rhinoplasty following open rhinoplasty. Plast Reconstr Surg 1995; 96: 1539-1546
  • 7 Sajjadian A, Rubinstein R, Naghshineh N. Current status of grafts and implants in rhinoplasty: part I. Autologous grafts. Plast Reconstr Surg 2010; 125: 40e-49e
  • 8 Sajjadian A, Naghshineh N, Rubinstein R. Current status of grafts and implants in rhinoplasty: Part II. Homologous grafts and allogenic implants. Plast Reconstr Surg 2010; 125: 99e-109e
  • 9 Lovice DB, Mingrone MD, Toriumi DM. Grafts and implants in rhinoplasty and nasal reconstruction. Otolaryngol Clin North Am 1999; 32: 113-141
  • 10 Kridel RW, Soliemanzadeh P. Tip graft in revision rhinoplasty. Facial Plast Surg Clin North Am 2006; 14 (4) 331-341
  • 11 Schuller DE, Bardach J, Krause CJ. Irradiated homologous costal cartilage for facial contour restoration. Arch Otolaryngol 1977; 103 (1) 12-25
  • 12 Welling DB, Maves MD, Schuller DE, Bardach J. Irradiated homologous cartilage grafts. Long-term results. Arch Otolaryngol Head Neck Surg 1988; 114: 291-295
  • 13 Jung DH, Choi SH, Moon HJ, Chung IH, Im JH, Lam SM. A cadaveric analysis of the ideal costal cartilage graft for Asian rhinoplasty. Plast Reconstr Surg 2004; 114: 545-550
  • 14 Song HM, Lee BJ, Jang YJ. Processed costal cartilage homograft in rhinoplasty: the Asan Medical Center experience. Arch Otolaryngol Head Neck Surg 2008; 134: 485-489
  • 15 Kridel RW, Konior RJ. Irradiated cartilage grafts in the nose. A preliminary report. Arch Otolaryngol Head Neck Surg 1993; 119: 24-30 ; discussion 30–31
  • 16 Adams Jr WP, Rohrich RJ, Gunter JP, Clark CP, Robinson Jr JB. The rate of warping in irradiated and nonirradiated homograft rib cartilage: a controlled comparison and clinical implications. Plast Reconstr Surg 1999; 103: 265-270
  • 17 Gryskiewicz JM. Waste not, want not: the use of AlloDerm in secondary rhinoplasty. Plast Reconstr Surg 2005; 116: 1999-2004
  • 18 Juri J. Salvage techniques for secondary rhinoplasty. In: Daniel RK, ed. Aesthetic Plastic Surgery: Rhinoplasty. Boston, MA: Little, Brown; 1993
  • 19 Costantino PD. Synthetic biomaterials for soft-tissue augmentation and replacement in the head and neck. Otolaryngol Clin North Am 1994; 27: 223-262
  • 20 Shirakabe Y, Shirakabe T, Takayanagi S. A new type of prosthesis for augmentation rhinoplasty: our experience in 1600 cases. Br J Plast Surg 1981; 34: 353-357
  • 21 Davis PK, Jones SM. The complications of silastic implants. Experience with 137 consecutive cases. Br J Plast Surg 1971; 24: 405-411
  • 22 Deva AK, Merten S, Chang L. Silicone in nasal augmentation rhinoplasty: a decade of clinical experience with implants. Plast Reconstr Surg 1998; 102 (4) 1230-1237
  • 23 Pak MW, Chan ES, van Hasselt CA. Late complications of nasal augmentation using silicone implants. J Laryngol Otol 1998; 112: 1074-1077
  • 24 Jung DH, Kim BR, Choi JY, Rho YS, Park HJ, Han WW. Gross and pathologic analysis of long-term silicone implants inserted into the human body for augmentation rhinoplasty: 221 revision cases. Plast Reconstr Surg 2007; 120: 1997-2003
  • 25 Conrad K, Torgerson CS, Gillman GS. Applications of Gore-Tex implants in rhinoplasty reexamined after 17 years. Arch Facial Plast Surg 2008; 10: 224-231
  • 26 Godin MS, Waldman SR, Johnson Jr CM. Nasal augmentation using Gore-Tex. A 10-year experience. Arch Facial Plast Surg 1999; 1: 118-121 ; discussion 122
  • 27 Ham J, Miller PJ. Expanded polytetrafluoroethylene implants in rhinoplasty: literature review, operative techniques, and outcome. Facial Plast Surg 2003; 19: 331-339
  • 28 Hobar PC, Pantaloni M, Byrd HS. Porous hydroxyapatite granules for alloplastic enhancement of the facial region. Clin Plast Surg 2000; 27: 557-569
  • 29 Friedman CD, Constantino PD, Sajjandian A. Alloplastic materials for facial skeletal augmentation. Facial Plast Surg Clin N Am 1999; 7 (1) 95-103
  • 30 Sclafani AP, Thomas JR, Cox AJ, Cooper MH. Clinical and histologic response of subcutaneous expanded polytetrafluoroethylene (Gore-Tex) and porous high-density polyethylene (Medpor) implants to acute and early infection. Arch Otolaryngol Head Neck Surg 1997; 123: 328-336
  • 31 Sajjadian A, Silver WE. Correction of external nasal valve collapse using high density polyethylene implants. In: Pastorek N, ed. The Seventh International Symposium of Facial Plastic and Reconstructive Surgery. New York:
  • 32 Silver WE, Sajjadian A. Nasal base surgery. Otolaryngol Clin North Am 1999; 32: 653-668
  • 33 Lowe NJ, Maxwell CA, Lowe P, Duick MG, Shah K. Hyaluronic acid skin fillers: adverse reactions and skin testing. J Am Acad Dermatol 2001; 45: 930-933
  • 34 Duranti F, Salti G, Bovani B, Calandra M, Rosati ML. Injectable hyaluronic acid gel for soft tissue augmentation. A clinical and histological study. Dermatol Surg 1998; 24: 1317-1325
  • 35 Maas CS, Papel ID, Greene D, Stoker DA. Complications of injectable synthetic polymers in facial augmentation. Dermatol Surg 1997; 23: 871-877
  • 36 Rudolph CM, Soyer HP, Schuller-Petrovic S, Kerl H. Foreign body granulomas due to injectable aesthetic microimplants. Am J Surg Pathol 1999; 23: 113-117
  • 37 Gunter JP, Rohrich RJ. Augmentation rhinoplasty: dorsal onlay grafting using shaped autogenous septal cartilage. Plast Reconstr Surg 1990; 86: 39-45
  • 38 Daniel RK, Brenner KA. Saddle nose deformity: a new classification and treatment. Facial Plast Surg Clin North Am 2006; 14: 301-312 , vi
  • 39 Sajjadian A, Guyuron B. An algorithm for treatment of the drooping nose. Aesthet Surg J 2009; 29: 199-206
  • 40 Cárdenas-Camarena L, Guerrero MT. Use of cartilaginous autografts in nasal surgery: 8 years of experience. Plast Reconstr Surg 1999; 103: 1003-1014
  • 41 Ortiz-Monasterio F, Olmedo A, Oscoy LO. The use of cartilage grafts in primary aesthetic rhinoplasty. Plast Reconstr Surg 1981; 67: 597-605
  • 42 Toriumi DM. Autogenous grafts are worth the extra time. Arch Otolaryngol Head Neck Surg 2000; 126: 562-564
  • 43 Brent B. The versatile cartilage autograft: current trends in clinical transplantation. Clin Plast Surg 1979; 6: 163-180
  • 44 Arslan E, Majka C, Beden V. Combined use of triple cartilage grafts in secondary rhinoplasty. J Plast Reconstr Aesthet Surg 2007; 60: 171-179
  • 45 Cárdenas-Camarena L, Gómez RB, Guerrero MT, Solis M, Guerrerosantos J. Cartilaginous behavior in nasal surgery: a comparative observational study. Ann Plast Surg 1998; 40: 34-38
  • 46 Bujía J. Determination of the viability of crushed cartilage grafts: clinical implications for wound healing in nasal surgery. Ann Plast Surg 1994; 32: 261-265
  • 47 Bateman N, Jones NS. Retrospective review of augmentation rhinoplasties using autologous cartilage grafts. J Laryngol Otol 2000; 114: 514-518
  • 48 McKinney P. An aesthetic dorsum. The CATS graft. Cartilaginous autogenous thin septal. Clin Plast Surg 1996; 23: 233-244
  • 49 Allcroft RA, Friedman CD, Quatela VC. Cartilage grafts for head and neck augmentation and reconstruction. Autografts and homografts. Otolaryngol Clin North Am 1994; 27: 69-80
  • 50 Parker Porter J. Grafts in rhinoplasty: alloplastic vs. autogenous. Arch Otolaryngol Head Neck Surg 2000; 126: 558-561
  • 51 Gruber RP, Pardun J, Wall S. Grafting the nasal dorsum with tandem ear cartilage. Plast Reconstr Surg 2003; 112: 1110-1122 ; discussion 1123–1124
  • 52 Sheen JHMD. The ideal dorsal graft: a continuing quest. Plast Reconstr Surg 1998; 102: 2490-2493
  • 53 Gunter JP, Rohrich RJ, Adams WP. Special emphasis on dorsal augmentation: Autologous rib cartilage. In: Dallas Rhinoplasty. St. Louis, MO: Quality Medical Publishing; 2002: 513-527
  • 54 Sherris DA, Kern EB. The versatile autogenous rib graft in septorhinoplasty. Am J Rhinol 1998; 12: 221-227
  • 55 Daniel RK. Rhinoplasty: septal saddle nose deformity and composite reconstruction. Plast Reconstr Surg 2007; 119: 1029-1043
  • 56 Daniel RK. Rhinoplasty and rib grafts: evolving a flexible operative technique. Plast Reconstr Surg 1994; 94: 597-609 ; discussion 610–611
  • 57 Gibson T, Davis WB. The distortion of autogenous cartilage grafts: its cause and prevention. Br J Plast Surg 1958; 10: 257-274
  • 58 Gunter JP, Clark CP, Friedman RM. Internal stabilization of autogenous rib cartilage grafts in rhinoplasty: a barrier to cartilage warping. Plast Reconstr Surg 1997; 100: 161-169
  • 59 Sajjadian A, Gordon C. Cartilage lamination in reconstructive rhinoplasty. (Manuscript in preparation)
  • 60 Ohara K, Nakamura K, Ohta E. Chest wall deformities and thoracic scoliosis after costal cartilage graft harvesting. Plast Reconstr Surg 1997; 99: 1030-1036
  • 61 Jackson IT, Choi HY, Clay R , et al. Long-term follow-up of cranial bone graft in dorsal nasal augmentation. Plast Reconstr Surg 1998; 102: 1869-1873
  • 62 Guerrerosantos J. Temporoparietal free fascial grafts to the nose. Plast Reconstr Surg 1985; 76: 328
  • 63 Miller TA. Temporalis fascia grafts for facial and nasal contour augmentation. Plast Reconstr Surg 1988; 81: 524-533
  • 64 Daniel RK. Diced cartilage grafts in rhinoplasty surgery: current techniques and applications. Plast Reconstr Surg 2008; 122: 1883-1891
  • 65 Calvert JW, Brenner KB, DaCosta-Iyer M, Evans GR, Daniel RK. Histological analysis of human diced cartilage grafts. Plast Reconstr Surg 2006; 118: 230-236
  • 66 Cakmak O, Bircan S, Buyuklu F, Tuncer I, Dal T, Ozluoglu LN. Viability of crushed and diced cartilage grafts: a study in rabbits. Arch Facial Plast Surg 2005; 7: 21-26
  • 67 Daniel RK. Discussion: block and surgical-wrapped diced solvent preserved costal cartilage homograft application for nasal augmentation. Plast Reconstr Surg 2005; 115: 2094-2097
  • 68 Erdogan B, Tuncel A, Adanali G, Deren O, Ayhan M. Augmentation rhinoplasty with dermal graft and review of the literature. Plast Reconstr Surg 2003; 111: 2060-2068