title: Rhinoplasty and rib grafts: evolving a flexible operative technique.
abstract: A flexible operative technique for utilizing rib grafts in difficult rhinoplasty and nasal reconstruction cases requiring support is presented. An osseocartilaginous rib segment is used for dorsal contour or support, while a rigid cartilaginous strut provides for both tip projection and columellar contour. The bone is contoured extensively, while the cartilage is altered minimally. An open approach is employed. A bony fixation platform is established by radix reduction followed by bony fixation with ultramicroscrews. Distally, the grafts are united when nasal lengthening or total support is required; otherwise, the grafts are juxtaposed to allow lateral movement. The operative technique and technical difficulties are described in detail based on experience in 14 patients.
authors.affiliation: Division of Plastic Surgery, University of California, Irvine, Newport Beach.
authors.forename: R K
authors.initials: RK
authors.lastname: Daniel
mesh_terms: D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D003042:Cocaine; D005260:Female; D006801:Humans; D008297:Male; D009295:Nasal Bone / Q000293:injuries; D009667:Nose Deformities, Acquired / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012225:Rhinoplasty / Q000379:methods*; D012272:Ribs / Q000637:transplantation*; D012887:Skull Fractures / Q000601:surgery; D019966:Substance-Related Disorders / Q000150:complications
chemical_list: D003042:Cocaine