Radix graft complications. Any suggestions?

Question

I have revision rhinoplasty booked in few months, is it a good idea to have radix graft placed using your own septal cartilage or is it better to avoid, my radix is low but not very deep, how common is this procedure?

Michael T. Somenek, MD · Answer

A radix graft can be very effective to augment that region of the nose. Frequently using your own cartilage is preferred and the septum is the most common location for a cartilage graft.

Sam P. Most, MD · Answer

Radix grafts can be very useful for treating the low radix.  In general, I find it best to use very soft material.  Cartilage is fine if it is 'softened' up (morselized) before being placed.  In addition, temporalis fascia can work nicely for small amounts of augmentation.  More options exist. In the end, each situation is different and your surgeon will have to determine what s/he thinks would work best for you.

Stephen Weber MD, FACS · Answer

A radix graft can be very helpful in properly selected patients. If you truly have a low radix this is the only way to achieve a pretty dorsal line without over reducing your nasal bridge. I like to use fascia as a radix graft as opposed to cartilage as this has a lower risk of becoming visible over time. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

William Portuese, MD · Answer

A radix graft is placed for patient'sw ho have a low bridge that it is used to build up the bridge line. The most common source of cartilage used for the grafting site or material is nasal septal cartilage. A  minimally low radix is probably left alone and can be adjusted by only the hump removal below it. A deep radix will require a cartilage graft. Rhinoplasty is one of the hardest operations to perform correctly in the entire field of cosmetic surgery, so choose your rhinoplasty surgeon very wisely based on experience. That surgeon will have plenty of experience with radix grafts

Robert S. Schmidt, MD · Answer

Thanks for your question. Radix grafts are used to either raise a low radix or to camouflage a dorsal hump. If you have a hump, one way of dealing with it is to shave it down. This will lower your nasal bridge. If your nasal bridge height is good, you wouldn't want to lower it. So then, you can add height above a hump which would make the hump less obvious. I don't use this technique a lot, but it is standard in the field. And yes, using septal cartilage is also the gold standard. Good luck with your surgery.

Dennis Barek, MD (retired) · Answer

Radix grafting is commonly done to set the radix at the level of the upper lid lashes. If the radix is significantly lower, then it would require too much dorsum to be removed, during the elimination of the hump. If you lower a dorsum too much, you create a significant disharmony between the nasal parts.In my practice, I would say perhaps 10%, or less, of primary rhinoplasties get a radix graft. The graft material is always your own septal cartilage.

Radix graft complications. Any suggestions?

Answers (6)

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