A novel autologous scaffold for diced-cartilage grafts in dorsal augmentation rhinoplasty

Overview

Diced cartilage is a flexible way to raise the nasal bridge, but it needs a wrapper to hold the pieces in place. Earlier wrappers, such as Surgicel or temporalis fascia, were linked to inflammation and shrinkage. The authors describe holding diced cartilage together with an autologous tissue glue made from the patient's own platelet-rich and platelet-poor plasma.

Sections of note

• Prospective analysis of 68 patients treated between 2005 and 2008.
• Construct: autologous diced cartilage stabilized with autologous tissue glue (ATG), combining platelet gel from platelet-rich plasma and fibrin glue from platelet-poor plasma.
• The construct is described as malleable, shaped for dorsal augmentation.
• Mean follow-up 15 months.
• Dorsal height was notably maintained.
• No complications required explantation.
• The abstract reports no measured height change and no minor complication counts.

What it means for a patient

• The bridge can be raised with the patient's own cartilage and own blood-derived glue, with no foreign material.
• In this series nothing had to be taken out over about 15 months.
• Single-center series with no comparison to fascia-wrapped diced cartilage; the abstract gives no objective measure of how much height was kept.

Why this paper matters

Diced cartilage wrapped in fascia became a standard for dorsal augmentation in the 2000s. This paper offers a fully autologous carrier that avoids a second donor site for fascia. Long-term resorption and comparison with other carriers remain unanswered.

Terms

• Diced cartilage: cartilage cut into small cubes so it can be molded to shape.
• Dorsal augmentation: raising the height of the nasal bridge.
• Platelet-rich plasma (PRP): the fraction of the patient's blood concentrated in platelets, a source of growth factors.
• Fibrin glue: a clotting-protein adhesive; here made from the patient's platelet-poor plasma.
• Temporalis fascia: the tough tissue layer over the temple muscle, often used to wrap diced cartilage.
• Explantation: surgical removal of a graft or implant.