Section 4 Plastic and Reconstructive Problems

Five patients have undergone dorsal augmentation using diced septal, auricular, or costal cartilage solidi- fied using tissue sealant, and no resorption of the grafts have been observed, with the longest follow-up of 9 months. Compared with the patients I treated using diced cartilage contained within a fascial tube, the patients treated using diced cartilage and tissue sealant appear to have considerably less long-term edema of the nose. This may be related to a more rapid incorporation of the graft by early revascularization of the diced cartilage. Accepted for Publication: March 18, 2012. Published Online: June 18, 2012. doi:10.1001 /archfacial.2012.494 Correspondence: Shan R. Baker, MD, Facial Plastic and Reconstructive Surgery, University of Michigan–Center for Facial Cosmetic Surgery, 19900 Haggerty Rd, Ste 103, Livonia, MI 48152 (shanb@med.umich.edu). Financial Disclosure: None reported. 1. Sheen JH. The ideal dorsal graft: a continuing quest. Plast Reconstr Surg . 1998; 102(7):2490-2493. 2. Erol O¨ O. The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg . 2000;105(6):2229-2243. 3. Elahi MM, Jackson IT, Moreira-Gonzalez A, Yamini D. Nasal augmentation with Surgicel-wrapped diced cartilage: a review of 67 consecutive cases. Plast Re- constr Surg . 2003;111(3):1309-1321. 4. Daniel RK, Calvert JW. Diced cartilage grafts in rhinoplasty surgery. Plast Re- constr Surg . 2004;113(7):2156-2171. 5. Calvert JW, Brenner K, DaCosta-Iyer M, Evans GRD, Daniel RK. Histological analy- sis of human diced cartilage grafts. Plast Reconstr Surg . 2006;118(1):230- 236. 6. Yilmaz S, Erc¸o¨c¸en AR, Can Z, Yenidu¨nya S, Edali N, Yormuk E. Viability of diced, crushed cartilage grafts and the effects of Surgicel (oxidized regenerated cellulose) on cartilage grafts. Plast Reconstr Surg . 2001;108(4):1054- 1062. 7. Brenner KA, McConnell MP, Evans GRD, Calvert JW. Survival of diced cartilage grafts: an experimental study. Plast Reconstr Surg . 2006;117(1):105- 115. 8. Kelly MH, Bulstrode NW, Waterhouse N. Versatility of diced cartilage-fascia grafts in dorsal nasal augmentation. Plast Reconstr Surg . 2007;120(6):1654- 1659. 9. Tasman A. Diced cartilage glue: a morphometric analysis. Presented at: Ad- vances in Rhinoplasty; May 6, 2011; Chicago, IL. 10. Bullocks JM, Echo A, Guerra G, Stal S, Yuksel E. A novel autologous scaffold for diced-cartilage grafts in dorsal augmentation rhinoplasty. Aesthetic Plast Surg . 2011;35(4):569-579. REFERENCES

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Figures 5. Preoperative views (A, C, and E) and 9 months following (B, D, and F) costal cartilage L-strut reconstruction and diced cartilage dorsal graft.

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