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Correction of Overresection With Diced Cartilage Injection
The Problem
The saddle nose previously corrected with carved costal cartilage, after 4 years was bent and subtotally resorbed. After removal of the remaining costal cartilage graft, a severe saddleback dorsum was evident.
The Background
In 1996, Skoog reported using resected dorsal hump as an autograft to correct an overly resected hump. Potential autografts for dorsum augmentation include septal, conchal, or rib cartilage and calvarium or iliac bone. Another source is an allograft of costal cartilage. Cartilage grafts have been widely used to improve the contour of the nose. In secondary rhinoplasty, the anatomy is distorted, the tissues are scarred, and the vascularity is diminished. In addition, a considerable amount of cartilage is necessary to correct depressions, the length of the nose, and the projection of the columella. I prefer to use costal cartilage harvested from the patient; however, if the patient does not accept this, an allograft of costal cartilage is used. For augmentation and lengthening, carved costal cartilage has been used widely. However, warping and a late show are well-known problems of carved costal cartilage.
The Indications
Correction of severe depression of dorsum, nasal valve discrepancy, lateral wall depression, tip projection deficiency, cripple nose.
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