Dorsal bone augmentation?
Doctor Answers 7
Most surgeons will use cartilage grafts to add volume to the dorm, and this won't ossify, but will scar in with the adding structures.
Dorsal Bone Augmentation
The bridge of the nose is best augmented using cartilage taken from the septum, ears, or ribs. It does not ossify but does become integrated into the surrounding normal tissue so that it will not shift or extrude after healing is complete, avoiding these complications which may occur long after placement of synthetic grafts.
Dorsal onlay graft
Hello and thank you for your question. A dorsal onlay graft consisting of a cartilage graft does much better than a bone graft in the nose for the purpose of dorsal augmentation. Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
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There are a number of options for dorsal augmentation in rhinoplasty
Among the options for dorsal augmentation are your own tissues such as septum or rib cartilage. Also some surgeons use implants made of Gortex or Silicone. I personally prefer natural materials. These can be solid grafts of cartilage or diced cartilage reconstituted with tissue glue or wrapped in fascia. A well formed natural implant does not necessarily ossify but sits solidly on the nose so you can't tell its not natural.
The issues for nasal grafts to the nasal dorsum is whether they will persist or resorb. The choice of graft can vary depending on the situation. They are frequently obtained from the nasal septum, ear or ribs. It should be noted that although uncommon, any graft can resorb over time. If it were to resorb a repeat graft might be necessary.
If you mean wil a bone graft work then the answer is that generally bone grafts on the nose are unpredictable and tend to resorb - cartilage grafts will incorporate and stick down nicely and feel exactly like bone and are the gold standard
Although there are several options for augmenting the dorsum, cartilage grafts are the most commonly used by Board-Certified plastic surgeons. After the graft has healed in place, it incorporates making it look and feel like a bony dorsum.