24.0: Thursday, March 17, 2005

Alloderm As An Adjuvant in Rhinoplasty

Patrick J. Proffer, MD, Malcolm W. Marks, MD, Lisa R. David, MD, and Louis C. Argenta, MD.

Both aesthetic and reconstructive rhinoplasty often require harvest of autologous cartilage to accomplish pre-operative goals. For more significant structural support, bone (most often from the rib or calvarium) is necessary. Some patients, however, are unwilling to undergo the additional morbidity of bone harvest. This especially limiting in patients needing significant dorsal augmentation.

We present our experience with two patients undergoing rhinoplasty requiring considerable augmentation of the nasal dorsum. The first is a saddle-nose deformity from a previous repair of a cleft lip nasal deformity. The second is an Asian rhinoplasty to correct a broad, low nasal dorsum. Both patients underwent harvest of all available cartilage from the ear and nasal septum. These grafts were fashioned into the appropriate shape and enclosed in an Alloderm shell. The resulting composite implant gave a smooth, well-defined nasal dorsum.

In addition, we present our experience using Alloderm to correct a difficult, recurrent septal perforation.