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

TL;DR

This study shows that using morselized bone grafts from discarded bone rasp material is a safe and effective method for refining the nasal dorsum and camouflaging irregularities in rhinoplasty.

Contribution

The study introduces the use of autologous bone rasp material as a novel, low-morbidity option for nasal dorsum contour refinement.

Findings

MBG had a low infection rate of 2.7%, all resolved with antibiotics.

Only 1.7% of patients required operative revision.

MBG provides a safe alternative with no additional donor-site morbidity.

Abstract

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.

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.

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.

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. Sixteen patients (1.7%) required operative revision.

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 esthetics, specifically camouflaging minor irregularities, with no additional donor-site morbidity when paired with boney dorsal reduction.

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