Augmentation Rhinoplasty Surgery :
Nose may be required for tip, for dorsum or both.
Rhinoplasty : (Means augmentation of bridge of nose) needed
in congenital depressed nose or post traumatic depression
saddle noses or to match with elevated tip of nose.
for dorsum augmentation -
1) Nasal Septal Cartilage (best option - but limited supply- we are seeing
lack of septal cartilage in most of revision rhinoplasty cases coming to us. Septal cartilage was removed in previous
surgery and wasted. Septal cartilage is the most valueble source of cartilage and should not be thrown away without
any obvious reason.
2) Choncal (Ear)
cartilage -Next to best but very limited supply.
3) Rib or
Coastal cartilage - needs incision over chest wall , very prone to warping.
4) Pelvic bone -
good source with minimum morbidity.
Calvarial Bone : Skull bone - outer table - best matches with facial bone and long lasting.
patients usually dont accept incision over head due to fear of cranial complication, which is very uncommon.
5) Bone graft from ulna - best avoided, risk benefit ratio not acceptable.
Synthetic Materials : Silicone, medpore , goretex etc.- all are secondary choices.
Tip Augmentation : (
Augmentation Tip-plasty or Tip rhinoplasty ): Tip augmentation is primarily done by manipulation of local cartilage there and very rarely any graft is required.
Implants are best avoided in tip.
Some short of tip plasty for narrowing and elevation or depression is
required in all cases of rhinoplasty.
of both Dorsum & Tip : This is the most common situation.