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Figure 6 This patient underwent prior rhinoplasty with overresection of the dorsum and persistent overprojection of the nasal tip. To create a more harmonious appearance, the tip was deprojected with excision of the lower lateral cartilages at the dome, and the nasal tip was resupported with a tip graft. Dorsal onlay grafting and reconstructive grafting of the nasal sidewalls were undertaken.
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AURICULAR CARTILAGE: APPLICATIONS Although each auricular cartilage graft must be carved in such a fashion as to meet the specific needs of the patient, considerable grafting requirements can be fulfilled by one piece of ear cartilage if carving of the cartilage is well planned. In this patient example, two alar batten grafts, a tip graft, a columellar strut, and additional grafting materials were available (Fig. 5). Due to the patient's relatively thin skin, a layer of soft tissue was left on the posterior surface. Indeed, if the patient has thin nasal skin, then the surgeon may wish to leave a portion of soft tissue on the posterior surface of the auricular cartilage. This allows some additional camouflage and also provides for more rapid tissue adhesion.
In each of the next two patient examples, alar bat-ten grafts, a dorsal onlay graft, tip graft, and a strut were carved from single auricular cartilage grafts (Figs. 6, 7).
The saddle nose is a common problem seen after trauma and after misadventures in rhinoplasty. In moderate deformities, either single or multilayered cartilage grafts can be undertaken. When septal cartilage is not available, auricular cartilage is the senior author ' s preferred graft material (Fig. 8).
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