Guide to Grafts in Rhinoplasty
Rhinoplasty is the surgical technique of reshaping the nose to improve either its appearance or function. During the course of a rhinoplasty, in some cases grafts may be used to support or improve the appearance of the nose.
The term graft typically refers to affixing one type of tissue to another. The framework of the nose is made up of cartilage, bone, and connective tissue. Most grafts in the nose are made up of cartilage and help serve to support the structure of the nose for either functional or aesthetic purposes.
Most grafts here are made up of cartilage. The nasal septum typically has enough cartilage to create a graft to be placed in other parts of the nose. However, sometimes it is necessary to harvest cartilage from the ear (auricular cartilage graft), rib (costal cartilage graft).
Grafts in rhinoplasty can be used through either an endonasal (closed) approach or external (open) approach. Some grafts are optimally used with either one or the other technique.
The goal in rhinoplasty is not to use as many grafts as possible, to selectively implement their use if the patient will see a benefit from their use. There are many types of grafts which can be used in rhinoplasty. The purpose of this guide is to help illustrate some of the more commonly used grafts in rhinoplasty, both in diagram and photographic example. Grafts have the advantage to help reshape the nose in numerous ways, allowing both the surgeon and patient more flexibility in aesthetic outcomes. Grafts which underneath the surface of the structure of the nose are termed invisible grafts. Some examples of invisible grafts are caudal extension grafts, columellar struts, and spreader grafts. Grafts which are closer to the surface of the skin are termed visible grafts. Some examples include shield grafts and dorsal grafts.
Types
Alar Batten Grafts
Alar Rim Grafts
Spreader Grafts
Lateral Crural Strut Grafts
Shield Grafts
Caudal Extension Grafts
Columellar Struts
Onlay Grafts
Radix Grafts
Dorsal Augmenation Grafts
Composite Graft
Plumping Graft
Harvesting Grafts
Septal Cartilage
Auricular Cartilage
Costal Cartilage
Frequently Asked Questions
Does my nose need a graft?
Dr. Shah will perform a thorough examination and history. Based on your aesthetic and functional needs, he can determine the benefits of a graft being used in the nose.
Why use a graft in my nose?
Some noses are deficient in cartilage support either from previous rhinoplasty or naturally. In order to provide the shape in certain noses, a graft may be beneficial.
Does this site list all rhinoplasty grafts?
There are many grafts which are used in rhinoplasty, some of which do not have names and some of which have multiple names. The purpose of this section is to mention many of the available grafts and the rationale behind their use. Other grafts which exist include extended columellar tip graft, peapod graft, peck graft, plumping grafts, soft tissue facet grafts, composite grafts.
Can anything be used as a graft in rhinoplasty?
Technically, any material can be placed in the nose, i.e. silicone, med-por, gore-tex. I don’t place artificial grafts for a variety of reasons, one of which is risk of infection, extrusion.
Are their risks with placing grafts in my nose?
Their are risks with any procedure. The main risks with graft placement are potential visibility or asymmetries. Dr. Shah is very careful to place each graft with care and precision to minimize this risk. Not placing a graft in specific patients may hold more risk, i.e. collapse of certain areas.
“The nose should fit the face”
A strong jawline would suggest a stronger nose.
