RHINOPLASTY surgery consists of hump removal, shortening and narrowing of the nose, and, in some instances, the insertion of grafts and implants. It is generally agreed that autogenous bone and cartilage are the best materials for grafting; silicone in solid or liquid form is still under investigation as an implant material and looks promising.
With the passage of time it became apparent that some unoperated upon noses would benefit by being lengthened and that techniques had to be developed to handle satisfactorily secondary operations, alar collapse, posttraumatic cicatrization, and the reconstruction of partial nasal defects. Such cases generally appear with missing bony and cartilagenous elements, scar-tissue contracture, and insufficient outer (skin) or inner (mucous membrane) lining. Simple scar excision and soft-tissue replacement is unsatisfactory because of the tendency of skin and mucous membrane to shrink after transplantation and, besides, scar-tissue removal leads to new scar formation. To counteract these eventualities,
Walter CD. Composite Grafts in Nasal Surgery. Arch Otolaryngol. 1969;90(5):622–630. doi:10.1001/archotol.1969.00770030624018
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