Grafts in Rhinoplasty: A Guide to Nose Grafts

Grafts in rhinoplasty are used to achieve specific goals such as creating definition in thick skin noses, making a nose appear straighter, correcting a collapse or indentation in the nose, providing tip support to prevent the nose from drooping, or correcting a saddled (scooped) or pinched nose in revision rhinoplasty.

Nasal Bridge Augmentation

Nasal Bridge Augmentation is performed to enhance the profile of the nose by placing grafts along the dorsum, increasing height and creating a defined contour. Precise shaping and placement ensure a balanced, natural-looking result while improving nasal stability. It is particularly beneficial for individuals with a low nasal bridge, boosting facial harmony while maintaining natural functionality and structural integrity.

Tip Refinement

Tip refinement focuses on shaping the nasal tip, achieving a balanced, aesthetically pleasing profile. Dr. Rizk reshapes tip cartilage and carefully adjusts underlying support structures, paying close attention to each patient’s individual nasal anatomy. Grafting options vary, including cartilage from the septum or ear to ensure stability and contour. This precise approach elevates tip definition while preserving essential function and it is ideal for addressing bulbous, droopy, or asymmetrical tips.

Correcting Asymmetry

Correcting nasal asymmetry with rhinoplasty often involves careful graft placement and precise cartilage manipulation. Dr. Rizk evaluates imbalances in nasal structures, and then selectively reshapes or reinforces these areas to restore symmetry. Techniques may include reshaping the nasal tip, adjusting bridge height, or correcting nostril alignment. The ultimate goal is a harmonized nasal contour that complements overall facial proportions while preserving function.

Improving Breathing and Airflow

Improving breathing and airflow is a fundamental objective in functional rhinoplasty. Grafts and structural adjustments can correct collapsed or narrowed nasal passages, address septal deviation, or reinforce weakened cartilage. By restoring proper support to the nasal framework, patients can experience enhanced nasal function, increased comfort, and reduced breathing difficulties, while simultaneously benefiting from aesthetic improvements and improved overall nasal harmony.

Dr. Rizk is revolutionizing rhinoplasty with an innovative technique that yields neater, more discreet results. Dr. Rizk uses powered sanding tools, rather than a traditional scalpel, for an even smoother finish when sculpting each nose he operates on. This method produces curves that are less noticeable and more aesthetically pleasing! Dr. Rizk’s practice exceeds the standard of nose reshaping, as he takes extra precautions to place grafts deeply under the nasal muscle to provide additional support for those with thin skin.

Rhinoplasty Consultation

During a comprehensive pre-procedure consultation with Dr. Rizk, patients discuss their nasal goals, medical history, and expected outcomes. Dr. Rizk assesses the nose, explains graft options, and addresses any concerns.

Rhinoplasty Grafts Surgery

A grafts-based rhinoplasty with Dr. Rizk begins with a detailed consultation and advanced 3D imaging to align surgical goals with your aesthetic and functional needs. In the operating room, Dr. Rizk uses precise surgical techniques to harvest and shape grafts, which may be sourced from cartilage in the septum, ear, or ribs. These grafts are meticulously placed to reinforce nasal structure, improve airflow, and refine the nose’s appearance. Using endoscopic methods and minimal incisions, Dr. Rizk ensures accurate graft placement, seamless integration with existing tissue, and natural-looking results, all while minimizing recovery time with personalized post-operative care.

There are several types of grafts that can be used in rhinoplasty, each with its own purpose. Grafts are placed with either the open (external) rhinoplasty approach or the endonasal (internal) closed rhinoplasty approach. The following are some of the more common grafts Dr. Rizk uses, but this list is by no means complete. In fact, some grafts used have no name.

Cartilage Graft Rhinoplasty

The most common type of graft used in rhinoplasty is a cartilage graft, which can be sourced either from the patient’s own body (autograft) or from another person (allograft). Cartilage grafts are typically used to increase nasal projection, reshape the nasal tip, and provide support for a collapsed or weak bridge.

Composite Graft or Ear Cartilage Graft

Composite graft combines skin and cartilage from the ear, providing both structural support and coverage for nasal defects. It is commonly used for reconstructing nostril rims, correcting alar retraction, and restoring natural contour and function.

Shield Graft

Used to fortify the nasal tip and achieve better projection and definition. It’s meticulously positioned in front of the tip cartilages, refining shape while preserving structural support.

Columellar Strut

Columellar strut is placed between the medial crura to strengthen nasal tip support and stabilize the columella. It helps maintain projection and refine tip shape and alignment.

Tip Onlay Graft

Tip onlay graft is placed over the nasal tip cartilages, enhancing definition and projection. Ear cartilage from the conchal area is an excellent option for a tip onlay graft.

Camouflage Graft

A type of onlay graft used to mask minor surface irregularities or prominent edges on the nasal framework. It helps create a smoother, more refined nasal contour while preserving function.

Caudal Extension Graft

Caudal extension graft is positioned at the nasal septum’s caudal end to lengthen and reinforce tip support. Harvested cartilage (often from the septum) helps achieve improved tip alignment, projection, and overall balance.

Spreader Graft Rhinoplasty

A spreader graft nose graft is used to widen a middle vault collapse and to correct an inverted V deformity. They are placed between the upper lateral cartilage and septum.

Alar Batten Graft

Used to support the external nasal valve and goes lateral to the lower lateral cartilages to correct a “pinched nasal tip”-used frequently in revision rhinoplasty. Helps prevent the collapse of the alar when breathing in.

Dorsal Augmentation Graft

Dorsal augmentation graft is applied along the nasal bridge to improve height and shape. Typically fashioned from cartilage, it helps correct contour irregularities and refine the nose’s overall profile.

Plumping Grafts

This is a graft placed at the nasolabial angle and is used to augment or improve a retracted columella. This graft can make the nose appear shorter.

Rib Graft Rhinoplasty

Rib graft rhinoplasty employs cartilage from the patient’s rib for robust support and augmentation. It is the last resource for revision cases, providing precise contouring and improved nasal function.

Radix Graft

This graft is placed in the angle between the nose and forehead (nasofrontal angle) to change the angle and make it look less deep. This makes the nose appear longer. Dr. Rizk likes to crush this graft made of cartilage to make it less visible and place it deep in the nasofrontal area under the muscle.

Alar Rim Graft

This graft is placed along the edge of the nostrils to also improve a pinched tip appearance or a retracted nostril. Dr. Rizk prefers to use soft ear (conchal) cartilage or septal cartilage for this graft.

Cartilage graft rhinoplasty is generally safe, though potential risks include infection, delayed healing, graft warping or resorption, and donor site complications. However, Dr. Rizk’s expertise and comprehensive surgical techniques minimize these risks significantly. His extensive preoperative planning and precise execution ensure a smoother recovery and natural, lasting results.

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