Augmentation Rhinoplasty Part 1 Showing Septal Cartilage Grafts
Video transcript: This is a case study of an augmentation rhinoplasty and what we mean by that is we want to actually augment some of the nasal features rather than reduce them. So in this case study we have a patient who wished to augment the height of her bridge and also make her tip look more defined. The underlying cartilages appear like this and what we want to do is we want to actually project the tip forward by using her own cartilage and where do we get the cartilage from? Well we actually take it from this cartilage inside the nose called the nasal septum so we have skematically removed that cartilage so I can show you where I have take the cartilages from.
What I do is I shape cartilages, shape grafts that I am going to use to augent her tip from her septal cartilage and this is what we call a shield graft, this is a columellar strut and these are cap grafts. There is actually plenty of cartilage in the nasal septum to make all of these grafts for a person so once we harvest the cartilage and make the grafts we can use it throughout the surgery. Cartilage grafts are harvested in most cases from the nasal septum of that individual we can sometimes take that cartilage from the ear as well if there is not enough cartilage in the nasal septum.
Essentially these cartilages are hand carved and they are shaped to the requirements of the individual patient. In this particular case I needed three types of graft, I needed two very small grafts that we call cap grafts and something called a strut or columellar strut and something called a shield graft and I will show you where I placed those to augment her tip. Once the cartilages are harvested then we can use them throughout the surgery now this is obviously an enlarged view this is actually real life assuming your screen is the same size as mine, this cartilage is about 9 – 10mm wide so that is the width at the very top and then this is probably 4 mm wide and the same thing for these.
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