Rhinoplasty is a surgical procedure aimed at improving the nasal shape and function, with dorsal augmentation playing a crucial role in nasal reconstruction. Autologous cartilage grafts, particularly from the rib, are widely used due to their structural integrity but pose challenges such as postoperative warping, graft shifting, and resorption. The evolution of cartilage grafting techniques has progressed from block to sliced and diced cartilage to enhance long-term stability and aesthetic outcomes. Block cartilage provides excellent structural support but is prone to warping due to intrinsic stress. Sliced cartilage reduces warping risk while offering greater flexibility, whereas diced cartilage allows for precise contour adaptation but has a higher risk of resorption. Modifications such as autologous fascia wrapping and fibrin glue application have been introduced to improve graft integration and stability. This study evaluates the effectiveness of each technique based on key parameters, including warping incidence, graft shifting, resorption, and aesthetic success. Literature review findings indicate that diced cartilage offers a more natural contour with minimal warping, while sliced cartilage provides a balance between structural support and flexibility. Block cartilage remains the preferred choice for major reconstruction requiring maximum strength. The selection of the grafting technique should be tailored to the patient's specific needs to optimize surgical outcomes and minimize complications.
Koento et al. (Tue,) studied this question.