This article reviews the author’s current techniques and applications of diced cartilage grafts (DCG) in rhinoplasty surgery. Dr Daniel is a renowned rhinoplasty surgeon and he describes the technique that he has been using for more than 30 years. In the last decade many variants of this technique have been described in the literature which underlines its popularity in rhinoplasty. DCG have a special role in nasal dorsal augmentation and in repairing other defects in rhinoplasty surgery. Three types of DCG are currently used by the author:  ‘diced cartilage, diced cartilage wrapped in fascia and diced cartilage covered in fascia’. In this study (two-year period and 546 rhinoplasty cases) he used DCG in 14% of cases (79 patients) with a total of 91 DCG in 34 primary and 45 secondary cases distributed in 27 diced cartilage, 21 diced cartilage covered with fascia and 43 diced cartilage wrapped in fascia. DCG was placed in the following locations: full length dorsum, peripyriform, half length dorsum, radix, infralobule and lateral wall. The article also reviews all rhinoplasty charts from 2006 (256 rhinoplasties, 19 months median follow-up) where 35 DCG were performed to 30 patients founding only two revisions unrelated to DCG. Technical problems are simple to solve and are: overcorrection, visibility and junctional step-offs. Advantages of DCG are: no chance of rejection of material, easy and fast preparation, any type of cartilage can be used, diversity of shape configuration, malleable during and up to 10 days postoperatively, minor revision rate and easy to correct, highly resistant to infection and no resorption reported in more than 200 cases in three years follow-up. Disadvantages: DCG are not appropriate for structural grafting. This is a very interesting article due to the vast experience of the author and the versatility of DCG. 

Diced cartilage grafts in rhinoplasty surgery: current techniques and applications.
Rollin K, Daniel, MD.
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Felipe Culaciati

Instituto de ORL & Cirugia Plastica Facial, Barcelona, Spain.

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