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Injection of Compressed Diced Cartilage in the Correction of Secondary and Primary Rhinoplasty: A New Technique with 12 Years’ Experience

Erol, O. Onur, M.D.

Plastic and Reconstructive Surgery: November 2017 - Volume 140 - Issue 5 - p 673e-685e
doi: 10.1097/PRS.0000000000003815
Cosmetic: Special Topics
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Background: There are instances where small or large pockets are filled with diced cartilage in the nose, without use of wrapping materials. For this purpose, 1-cc commercial syringes were used. The obtained results were partial and incomplete. For better and improved results, the author designed new syringes, with two different sizes, which compress the diced cartilage for injection.

Methods: The author presents his experience accrued over the past 12 years with 2366 primary, 749 secondary, 67 cleft lip and nose, and a total of 3182 rhinoplasties, using his new syringe design, which compresses diced cartilage and injects the diced cartilages as a conglutinate mass, simulating carved costal cartilage, but a malleable one.

Results: In 3125 patients, the take of cartilage graft was complete (98.2 percent) and a smooth surface was obtained, giving them a natural appearance. In 21 patients (0.65 percent), there was partial resorption of cartilage. Correction was performed with touch-up surgery by reinjection of a small amount of diced cartilage. In 36 patients (1.13 percent), there was overcorrection that, 1 year later, was treated by simple rasping.

Conclusions: Compared with diced cartilage wrapped with Surgicel or fascia, the amount of injected cartilage graft is predictable because it consists purely of cartilage. The injected diced cartilage, because it is compressed and becomes a conglutinated mass, resembles a wood chip and simulates carved cartilage. It is superior to carved cartilage in that it is moldable, time saving, and gives a good result with no late show or warping. The injection takes only a few minutes.

Istanbul, Turkey

From the ONEP Plastic Surgery Science Institute.

Received for publication January 3, 2017; accepted June 5, 2017.

Presented in part at the Rhinoplasty Society Meeting, in Las Vegas, Nevada, May 2009; the American Society for Aesthetic Plastic Surgery Annual Meeting, in Las Vegas, Nevada, May 2 through 7, 2009; the 20th Annual Meeting of the European Association of Plastic Surgeons, in Barcelona, Spain, May 28 through 30, 2009; the 22nd Annual Meeting of the European Association of Plastic Surgeons, in Mykonos, Greece, June 2 through 4, 2011; Plastic Surgery 2012: Annual Meeting of the American Society of Plastic Surgeons, in New Orleans, Louisiana, October 28 through 31, 2012; and the American Society for Aesthetic Plastic Surgery Annual Meeting, in Las Vegas, Nevada, April 2 through 7, 2016.

Disclosure:The syringe presented here is patented and royalties from this product are donated to a local cleft palete and birth defect charity.

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s website (www.PRSJournal.com).

O. Onur Erol, M.D., ONEP Plastic Surgery Science Institute, Manolyali Sk. No:15 Levent, 34330 Istanbul, Turkey, onurerolmd@onep.com.tr

Copyright © 2017 by the American Society of Plastic Surgeons