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Cartilage Recycling in Rhinoplasty: Polydioxanone Foil as an Absorbable Biomechanical Scaffold

James, Stuart E. F.R.C.S.(Plast.); Kelly, Martin H. M.D.

Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e31817741d3
Cosmetic: Original Articles
Abstract

Background: Primary and secondary rhinoplasty often requires multiple cartilage grafts. Polydioxanone foil may be used as a temporary biomechanical scaffold on which routinely discarded cartilage fragments can be assembled to make maximal use of harvested material.

Methods: The authors performed an outcome analysis of 58 primary and secondary rhinoplasties in which polydioxanone foil was used in combination with autologous cartilage for aesthetic and valvular reconstruction of the nose. Graft performance, complications, and technical points are reported.

Results: The temporary scaffold (polydioxanone foil) was used most often to construct columellar struts, septal extension grafts, and alar battens. Other uses included revision septoplasty and upper lateral replacement grafts. Two minor complications occurred: one infection and one partial extrusion. The long-term stability of the nose following this technique was found to be satisfactory (mean follow-up, 18 months), for both structural and aesthetic purposes.

Conclusions: This technique is both simple and effective. By making maximal use of otherwise discarded cartilage fragments, it protects other graft harvest sites and decreases the incidence of the “graft-depleted” patient.

Author Information

London, United Kingdom

From the Craniofacial Surgery Department, The Chelsea and Westminster Hospital.

Received for publication April 7, 2007; accepted October 5, 2007.

Presented at the British Association of Aesthetic Plastic Surgeons, in Bath, United Kingdom, September of 2006.

Stuart E. James, F.R.C.S.(Plast.); The Royal Marsden Hospital; Fulham Road; London SW3 6JJ, United Kingdom; stuartejames@gmail.com

Postscript: Since this paper was accepted for publication, Dr. James is saddened to report the untimely death of Martin Kelly. He was a truly inspirational colleague and a dear friend.

Disclosure: The authors have no financial interest in the product or company manufacturing the product used in this article, nor were any supporting funds made available for the study.

©2008American Society of Plastic Surgeons