Tip Graft and Columellar Strut Using Dorsal Osseocartilaginous Hump

Background: Although, different grafts are used for nasal tip plasty in cases with under projected or ill defined tip, the selection of a graft material, which provides sufficient amount of tissue with least donor site morbidity and low recipient site complication is challenging. The objectives of the present study were to examine the usefulness of cartilaginous dorsum as a proper material for tip graft, and to introduce the cartilaginous dorsum as an acceptable material for columellar strut. Methods: Fifty six (18 males and 38 females) patients were operated for augmentation tip plasty and hump reduction from 2004 to 2008. The tailored cartilaginous or ostecartilaginous dorsum was used as a tip graft or columellar strut in 35 and 21 cases, respectively. The cartilaginous framework was exposed using open or close rhinoplasty approach in 41 and 15 cases, respectively. The patients were followed for 12- 36 months. Cosmetic outcomes and patients' satisfaction were obtained using qualitative measures. Results: The percentage of patients with very improved, improved, unchanged or unacceptable aesthetic outcome were 39.29%, 50%, 3.57% and 7.14%, respectively. Moreover, the percentages of very satisfied, satisfied, indifferent and unsatisfied patients were 66%, 18%, 9%, and 7%, respectively. Conclusion: The procedure provides a well-defined nasal tip with no evidence of bifidity, angularity, or cartilage graft visibility and displacement. The use of dorsal osteocartilaginous graft offers outstanding advantages including ease of harvest, mould, fix, and low resorption.