This article shows the experience of a single surgeon with the use of diced conchal cartilage with perichondrial attachment in 37 consecutive patients. The graft was used to camouflage asymmetries on the lateral wall of the nose, for tip contouring and to raise the dorsum at the supratip area and the radix. Pre- and postoperative measurements of tip projection and rotation, dorsal height, radix height and nasal length were taken in order to find statistical evidence of external changes. Two independent surgeons blindly evaluated pre- and postoperative photos of the patients, assessing the aesthetic outcome of the procedures. Complications with harvesting of the cartilage and grafting were also analysed in the study. The results showed an excellent outcome in more than 70% of patients regardless of the area the graft was inserted. The authors state that diced cartilage is a much more consistent graft than crushed cartilage due to the reduced trauma of the tissue when cut by a scalpel. The attachment of one perichondrial layer provides an ease of manipulation and a lack of requirement for suture fixation, which is a substantial advantage over other types of cartilage grafts in rhinoplasty. The flexibility of the graft allows its placement in any area without the risk of visibility, excluding patients with thin skin. The downsides of this technique are the need of a donor area and the risks of over or under correction; this graft is not suitable for major dorsal augmentation either. This is a very interesting paper with clear scientific evidence and good images to support the data. Yong Ju Jang is one of the most reputed rhinoplasty surgeons in the world and his articles and presentations are always honest and full of knowledge. Definitively a must for facial plastic surgeons.

Use of diced conchal cartilage with perichondrial attachment in rhinoplasty.
Kim JH, Jang YJ.
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Eduardo Morera Serna

Hospital Universitario Son Espases, Palma de Mallorca, Spain.

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