This article will discuss all the nuances of augmenation rhinoplasty including:
- Auricular cartilage grafting
- Costal cartilage grafting
- Septal cartilage
- Alloplastic versus natural materials
This is a young patient who suffered complete nasal collapse. She had treatable granulamatous disorder where had a septal perforation and loss of all of her septal cartilage. Her entire nose must be rebuilt in order to restructure and improve her appearance.
After an extensive discussion, rib cartilage (costal cartilage) was discussed with the patient as the material for choice for reconstruction. An artificial material is not ideal for building the nasal tip and supporting the nose. Ear cartilage would be insufficient and lack enough strength.
The patient is shown here with an obvious deformity to the nose. This is also known as a saddle nose deformity. Her entire septum is missing and it is obvious on the lateral view. She lacks support to the tip of the nose which causes the nose to look flat, in addition to creating nostril flair on the frontal view.
Costal cartilage was used to reconstruct her entire nose. A part of the cartilage was used to reconstruct the nasal tip and a part was used to reconstruct the nasal bridge. Raising her bridge all the way to the radix would leave an overly augmented nasal bridge and too masculine of an appearance.
The postoperative frontal view demonstrated improved nasal tip definition and shadowing. While her alar base looks narrower on this view, no incisions were made to narrow this. The narrowing occurred with nasal tip projection.
The lateral view and oblique view demonstrated improved balance to the patients nose. The base view shows a nose with improved projection and nostril shape.
“The nose should fit the face”
A strong jawline would suggest a stronger nose.