Use of an Autologous Diced Cartilage Graft and Fat Graft Combination to Improve Regeneration in Rhinoplasty

Abstract

Background In rhinoplasty, many techniques are used to increase the permanence of the planned final shape of the nose. Cartilage grafts can be diced and applied directly to the nasal dorsum, or by wrapping with a material. We aim to show that mixing and using diced cartilage grafts with fat grafts can contribute to the viability of cartilage grafts by comparing our early postoperative and long-term results. Materials and Methods A total of 228 cases were analyzed. Postoperative 1-month, 6-month, and 1.5-year photographs of the patients were compared and the places that descended on the nasal dorsum were measured. In addition, dorsal height was measured and compared. Preoperative and postoperative first-year rhinoplasty outcome evaluation scales were performed. Specimens from 6 patients were examined histopathologically. Results After the first month, the mean regression in the dorsum was measured as 1.4 mm. The decrease in dorsal height between 1 month and 6 months was significantly greater than the decrease between 6 months and late periods. According to the rhinoplasty outcome evaluation (ROE) scale, the average preoperative score of the patients was 45, while the mean postoperative score was 81.5. The viability of chondrocyte cells was measured as 85–90% histopathologically. Conclusion This approach has been evaluated as an application that satisfies both the surgeon and the patient due to the advantages of fat grafts such as preventing the cartilage and osteotomy lines from being palpated in thinskinned patients, holding the diced cartilage grafts together by acting as a glue, increasing the viability of cartilage grafts. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.