Morselized Bone Graft: A Tool for Nasal Dorsum Refinement and Camouflaging

Background Refining the nasal dorsum to achieve a smooth and natural contour remains challenging, particularly in patients with thin skin who are prone to visible surface irregularities. Numerous techniques have been described to address these issues, including diced cartilage, fascial or dermal grafts, and synthetic implants. Objectives This study evaluates the outcomes of using morselized bone grafts (MBG), specifically, autologous bone rasp material that is typically discarded, as a method for nasal dorsum contour refinement. Methods A retrospective review was conducted of consecutive rhinoplasty procedures performed by the senior author between January 2021 and June 2022. Patients who underwent dorsal contouring with MBG and had at least 12-months of follow-up were included. The primary outcomes were postoperative infection and the need for revision surgery. Results A total of 953 patients met inclusion criteria. The mean patient age was 31.6 ± 11.3 years, and the mean follow-up duration was 23.5 ± 8.7 months. Postoperative infections occurred in 26 patients (2.7%), all of which resolved with antibiotic therapy. 16 patients (1.7%) required operative revision. Conclusions The use of MBG harvested from bone rasp material provides a safe and efficient option for achieving dorsal nasal smoothness and camouflaging minor contour irregularities in both primary and revision rhinoplasty. Additionally, MBG use is an efficient alternative to other techniques for addressing dorsal aesthetics, specifically camouflaging minor irregularities, with no additional donor-site morbidity when paired with boney dorsal reduction.