A cartilage punch of new design for use in rhinoplasty.
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Grafts to the nasal dorsum and tip, whose local effects are well known, also have distant effects that may not be as readily obvious but that nevertheless are just as real. Dorsal and tip grafts can shorten or lengthen the nose (relatively and absolutely), affect nasal symmetry, preserve or alter nasal ethnic characteristics, and alter dorsum/tip relationships. Each of these properties increases the utility of cartilage and bone grafts in treating a variety of nasal configurations.
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Many materials have been used as nasal implants. In our opinion, autogenous material only should be used for nasal augmentation and reconstruction. The indications and techniques for cartilage grafts from the rib, auricle, or septum are discussed.
Typical features of the ageing nose require intense preoperative planning and a careful surgical technique. The motives for the operation vary: generally, the patients only wish for minimal changes to reduce the most obvious features. Basic technical details are presented.
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