Crushed cartilage and fibrin sealant graft for radix augmentation
Reviewed by Eduardo Morera Serna

This paper shows a new technique for radix augmentation on Asian patients using crushed cartilage layers stacked on the nasal dorsum and stabilised with fibrin sealant. The study was made on 51 patients operated by the same surgeon in two consecutive years. Anthropometric measurements, patient self-assessment and independent postoperative review by two surgeons were performed in order to evaluate the success of the technique. Overall results showed a consistent increase in volume at the radix with a high rate of patient satisfaction, low rate of complications and an objective improvement on nasal aesthetics. The authors of the study compare their technique with Tasman’s dorsal augmentation surgery using diced cartilage stabilised with fibrin sealant stating the advantages of crushed cartilage over diced. Although the use of crushed cartilage for radix augmentation is not new, the use of fibrin sealant to stabilise the different layers of the graft seems a good idea since it facilitates the construction of a precise graft and makes the insertion into its pocket much easier. There is always the question of the long-term survival of the crushed cartilage that the authors address with a 15-20% overcorrection of the defect and the limit of dorsal augmentation accomplished with crushed or diced cartilage. If more augmentation than 3-4mm is necessary, costal cartilage grafts are needed, but anyway this is not common in Asian patients. This is a very interesting paper to read for any rhinoplasty surgeon; dealing with radix aesthetics is always a difficult issue, not just in Asian patients.

Combined use of crushed cartilage and fibrin sealant for radix augmentation in asian rhinoplasty.
Yu MS, Kim BH, Kang SH, Lim DJ.
PLASTIC AND RECONSTRUCTIVE SURGERY
2015;135(2):301e-2e.