What is a Graft and What is It Used for in Rhinoplasty?

A graft is a piece of tissue from one portion of the body which is placed in another. The most common grafts used during rhinoplasty are comprised of cartilage, taken from the septum, ear, or rib. The general purpose of these grafts is to change the shape of the nose by altering the underlying bony/cartilaginous framework. Certain grafts, such as spreader grafts, can be used to widen or support the nasal airway, to improve breathing. Besides cartilage, grafts can also be made of soft tissue, skin, bone or the mucosal lining of the nose. 

A graft is typically a biologic piece of material (most commonly cartilage but it can be skin, muscle, bone or fascia) that is used to achieve a desired change of the nose depending on what is required.

Grafts are either a portion of your body (such as cartilage, bone, or soft tissue) or artificial material (such as silicone, Gore-tex, Medpore, etc)  which serves to reshape the nose.  Grafts can be used in a functional capacity or to reshape the nose.  For more detailed information on grafts and their use in rhinoplasty see attached link.

There are a couple of categories of grafts.  

1.  Cartilage

        Ear

        Internal Nose

        Rib

2.  Bone

       Skull

       Rib

3. Synthetic

These grafts are used base what is available and what is needed to execute the rhinoplasty.  

Dr. ES

     

A graft is any tissue taken from one place in the body and placed in another area. With Rhinoplasty most grafts are cartilage. Some are bone and rarely there are skin and mucosa. The cartilage can come from your septum or from your ear.

Nasal graft usually refers to a piece of cartilage, bone or some other tissue that is used during rhinoplasty.  Typically this is patient's own cartilage, but can be banked tissue as well.  It is used for either structural and functional reasons, or for aesthetic reasons to achieve a particular nasal appearance.

As you probably have learned by now rhinoplasty is one of the more difficult procedures for a surgeon to master.  The decision to use a nasal graft when used properly can greatly enhance the surgical result.  It is imperative that an experienced and talented surgeon thoroughly assess the patient's facial anatomy and proportions. The goals is to create a beautiful nose with nice proportions that fits that particular face. In my practice we offer computer imaging to our prospective rhinoplasty patients, so that the goals and aspirations of the patients can be communicated. Of course not all surgeons that can created changes on the computer can produce those changes in the operating room. Pick you rhinoplasty surgeon carefully.

You might find it insightful to read my article "The Art of Sculpting the Nose" which can be found on my web site under "publications"
 

In rhinoplasty grafts are most commonly cartilage taken from the nasal septum, ear, or rib. These grafts are used to strengthen, restructure, camouflage, or re-orient certain areas of the nose.

Simply stated, a graft is a support structure placed underneath the skin of the nose to straighten, strengthen, or rebuild the cartilage framework. A graft usually refers to the patient's own tissue (autologous) but it can refer to synthetic (alloplastic )material such as solid silicone, medpor, Gortex, etc.
Most rhinoplasty surgeons prefer to use the patient's own septal cartilage for grafts, which is borrowed from the central portion of the nasal septum. For revision rhinoplasty in which the septal cartilage has already been used, surgeons frequently will use ear cartilage or rib cartilage.
Common uses of grafts in rhinoplasty include:

Columellar Strut - a graft placed in the column of tissue between the ostrils (columella) to provide the tip with support or to increase the amount of projection.
Tip Graft - cartilage placed overlying the tip to give more definition or projection to the tip.
Spreader Grafts - pieces of cartilage that are placed along either side of the top of the septum to help widen a narrow bridge or to open the nasal passages.
Alar Batten Grafts - placed in the sidewalls of the nostrils to prevent or correct nostril collapse
Dorsal Onlay Graft - graft placed along the bridge to add height (dorsal augmentation)

Cartilage that is
used for graft tissue, is often taken from your own nose (nasal septum) and is
used to either reinforce weakened areas of the nose from previous surgery or
trauma. Grafts are commonly used in revision rhinoplasty when excessive
cartilage has been removed from the nose.

With revision
surgery, sometimes all your natural nasal septum has been removed, in which
case other options depending on where it is required from the nose include
using ear cartilage (from a hidden part of the ear), or banked cartilage. The
first option from your own cartilage septum is preferred, the other two options
depend on the location and type of cartilage required.

For curved aspect
of the nose that require strengthening curved, Dr. De Silva prefers ear
cartilage as this creates a natural curve. For straight aspects of the nose
that require straightening, Dr. De Silva prefers straight septum or costal
cartilage. In some patients noses, different types of grafts are require to
strengthen and support different aspects of the nose.

There are synthetic
graft material that is available, however this is generally not preferred as it
is unnatural and can have risks such as infection and exposure of the material.

Grafts refer to any cartilage or other substance added to the nose during rhinoplasty surgery. Most commonly they are composed of cartilage, from either the nasal septum or ear, but occasionally they can be from a rib or a cadaver cartilage, or an artificial substance (which can work great) such as GoreTex. These grafts can be used for purely cosmetic purposes, such as with a tip graft along the dorsum/profile, or for both cosmetic and functional purposes, such as with a columellar strut to help hold up the tip or rim graft to give nicer shape to the nostril. To be used properly, grafts are usually best performed by an experienced rhinoplasty surgeon.