Journal archive · Revision and secondary rhinoplasty · Rib, ear and septal grafts · Nasal tip · Cleft, trauma and reconstruction · 2025
Secondary Cleft Rhinoplasty Using Circumferential Alar Rim Cartilage Graft: Surgical Technique and Morphometric Study
Moltaji S, Wang A, Cardemil F, Fialkov JA.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on alar rim grafts.
From the abstract
“Achieving symmetry in secondary cleft rhinoplasty is challenging even for the most skilled surgeon. The authors present their technique and outcomes of using a circumferential alar rim graft to relocate the cleft-sided anterior ala superiorly and anteriorly. The graft, under tension, is anchored to the septum at one…”
Excerpt; the full abstract is on PubMed.
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Revision and secondary rhinoplasty
Between 5% and 15% of rhinoplasties are done again, and the published series say the second operation is a different problem from the first: the cartilage is gone, the skin is scarred and less able to survive, and the airway is usually part of the complaint.
Rib, ear and septal grafts
Modern rhinoplasty builds rather than removes, so the operation runs on cartilage: the septum first, then the ear, then the rib, and when none of those will do, a piece of donated rib from a tissue bank.
Nasal tip
Tip surgery is now a support problem rather than a sculpting problem: the septal extension graft holds projection and rotation where the columellar strut loses them (0.2% against 4.7% projection loss at one year), and the current series repair, reposition and reinforce the lower lateral cartilages instead of excising them.
Cleft, trauma and reconstruction
A cleft nose is a sequence spread across a childhood: a repair at three months, sometimes a second at five or six, and a definitive rhinoplasty once the face has finished growing.
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