Please give specifics and not the standard line "in the hands an experienced surgeon"
Answer: Spreader grafts In the hands of an experienced concreter*, LVL (Laminated Veneered Lumber) beams are used to support the formwork for suspended slabs because they can tolerate major deforming forces whilst remaining straight and true. Despite the fact they are made from crappy thin bits of timber which wouldn't stay straight in a mild breeze. Spreader grafts are just like that, except not quite as good.
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Answer: Spreader grafts In the hands of an experienced concreter*, LVL (Laminated Veneered Lumber) beams are used to support the formwork for suspended slabs because they can tolerate major deforming forces whilst remaining straight and true. Despite the fact they are made from crappy thin bits of timber which wouldn't stay straight in a mild breeze. Spreader grafts are just like that, except not quite as good.
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July 30, 2019
Answer: Warping and rib cartilage Simple answer: two curved pieces with the concave sides facing each other and sutured to each other leads to a straight piece. Warping declares rather quickly in the OR and with a surgeon who understands that principle and waits until the direction of warping declares itself there won't be any trouble. There are very few grafts in the nose that should be perfectly straight and flat. Best,Thomas Walker, MD, FACS
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July 30, 2019
Answer: Warping and rib cartilage Simple answer: two curved pieces with the concave sides facing each other and sutured to each other leads to a straight piece. Warping declares rather quickly in the OR and with a surgeon who understands that principle and waits until the direction of warping declares itself there won't be any trouble. There are very few grafts in the nose that should be perfectly straight and flat. Best,Thomas Walker, MD, FACS
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July 30, 2019
Answer: How to prevent rib cartilage warping This is a highly technical question which, whilst it might be interesting to rhinoplasty surgeons, is of little value to prospective patients. Rib cartilage is a very useful material for major reconstructive work or if septal cartilage is not available. If you cut a strip of it lengthways, it does have a tendency to bend (try doing the same with a carrot and you'll see what I mean). You can get round this by using cartilage from the centre, rather than the edge but, failing that, you can use to slightly warped pieces and have them facing each other as spread grafts so that they cancel each other out. This is a useful trick but is by no means a guarantee that late warping will not occur. Unfortunately for you, the best piece of advice I can give is to find "an experienced surgeon" who knows how to handle the cartilage, cut it up judiciously and select the right pieces. I hope that gives you some insight
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July 30, 2019
Answer: How to prevent rib cartilage warping This is a highly technical question which, whilst it might be interesting to rhinoplasty surgeons, is of little value to prospective patients. Rib cartilage is a very useful material for major reconstructive work or if septal cartilage is not available. If you cut a strip of it lengthways, it does have a tendency to bend (try doing the same with a carrot and you'll see what I mean). You can get round this by using cartilage from the centre, rather than the edge but, failing that, you can use to slightly warped pieces and have them facing each other as spread grafts so that they cancel each other out. This is a useful trick but is by no means a guarantee that late warping will not occur. Unfortunately for you, the best piece of advice I can give is to find "an experienced surgeon" who knows how to handle the cartilage, cut it up judiciously and select the right pieces. I hope that gives you some insight
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July 30, 2019
Answer: Rib cartilage for spreader grafts Rib cartilage is a very useful material for spreader grafts in patients who have had previous septoplasty or have little septal cartilage. Septal cartilage is the ideal autologous graft material but rib cartilage is very useful when septal cartilage is not an option in certain cases. Rib cartilage is placed in an opposing fashion and sutured against the septum to prevent warping. Rib cartilage warping is more of a risk when used on bridge as an onlay graft or in the tip as a strut graft, but the risk of warping as a spreader graft is minimal.
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July 30, 2019
Answer: Rib cartilage for spreader grafts Rib cartilage is a very useful material for spreader grafts in patients who have had previous septoplasty or have little septal cartilage. Septal cartilage is the ideal autologous graft material but rib cartilage is very useful when septal cartilage is not an option in certain cases. Rib cartilage is placed in an opposing fashion and sutured against the septum to prevent warping. Rib cartilage warping is more of a risk when used on bridge as an onlay graft or in the tip as a strut graft, but the risk of warping as a spreader graft is minimal.
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July 30, 2019
Answer: Rib cartilage warping Rib cartilage warps to varying degrees primarily based on calcification of the rib which increases as you get older. In younger patients there are very few calcifications so the rib warps a lot. In contrast, older patients have more calcifications so it warps much less. Irradiated rib still has some warping tendencies as well but usually is pretty minimal.
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July 30, 2019
Answer: Rib cartilage warping Rib cartilage warps to varying degrees primarily based on calcification of the rib which increases as you get older. In younger patients there are very few calcifications so the rib warps a lot. In contrast, older patients have more calcifications so it warps much less. Irradiated rib still has some warping tendencies as well but usually is pretty minimal.
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