The Combined Auricular Graft: A New Technique for Mestizo Nasal Tip Surgery

Abstract

Abstract Background Current literature lacks a single cartilage graft to address problems in projection, rotation, and/or definition in mestizo patients that considers the alar cartilage structure, length, and shape characteristics of this population. Objectives The authors sought to describe a novel technique and evaluate the aesthetic outcomes of the combined auricular graft in mestizo patients undergoing primary rhinoplasty. Methods A retrospective cohort study of consecutive patients who underwent primary rhinoplasty using the combined auricular graft between January 2015 and June 2017 was performed. The minimum duration of follow-up was 6 months. Main outcomes were nasal tip projection and tip rotation angle. Results Among the 61 patients (38 women [62.2%] and 23 men [37.8%]; mean age, 29.3 ± 10.8 years), the mean differences in projection were statistically significant between T0 and T1, T0 and T2, and T0 and T3 (1.63, 1.39, and 1.32 mm, respectively). Thus, 80.9% of the increase in projection that had been achieved at T1 was maintained at T3 (P < 0.001). The relapse ratio measured 19.1% (mean difference T1-T3, 0.31 ± 0.10 mm). The mean tip rotation angle at T0 (111.69 ± 3.59°) significantly increased by 2.37 ± 3.13° (T3, 114.06 ± 2.50°, P < 0.001). Conclusions One single auricular cartilage graft can significantly improve projection and/or rotation by simultaneously addressing structure, length, and shape of lower lateral cartilages. Misbalance between the medial and lateral crura is avoided and retraction risks are prevented. Consequently, a more natural, precise, and accurate tip position is obtained. Level of Evidence: 4