THERE are times in the course of a rhinoplastic operation when a difficult decision must be made as to whether or not a cartilaginous graft should be used. I refer specifically to those cases in which minor depressions of the dorsal bridge or any part of the lateral walls are noticeable. It is possible that if these depressions are left alone, they may in time become filled with fibrous tissue and become unnoticeable. However, there is a greater risk that they will be very evident, thereby creating some obvious defects, such as a saddle nose if the dorsal bridge is very low, or a crooked nose if only one lateral wall is depressed.
Yet even though the graft is carefully fitted to the defect in every dimension, it is possible that after several days have passed an unpleasant and pronounced hump may appear which is most disturbing to both