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The manipulation of nasal tip cartilages, dorsal cartilages, and nasal bones during rhinoplasty surgery can frequently leave contour irregularities that can be difficult to manage. In these cases of dorsal or sidewall contour issues, onlay grafting may be required to achieve the ideal contour and shape. Ultimate patient and surgeon satisfaction is frequently dependent on an aesthetically pleasing dorsal contour. Crooked noses, dorsal sidewall, middle-third concavity deformities, open roof deformities, saddle nose deformities, and upper lateral cartilage inverted-V deformities can all result in a suboptimal outcome.
Butz DR, Warner J. Transcutaneous Securing Technique for Nasal Onlay Grafts. JAMA Facial Plast Surg. 2015;17(2):149-150. doi:10.1001/jamafacial.2014.1392