Tip rhinoplasty in broad noses in a Turkish population: Eurasian noses

Erol ÖO.

What this paper says

Over 20 years and 3,800 patients with broad, thick-skinned noses, the author reports that a "Turkish delight" graft of diced cartilage wrapped in Surgicel at the tip, with a columellar strut, gave the desired tip shape without the late visibility seen with solid grafts.

Overview

In Mediterranean, Anatolian and Middle Eastern populations the nasal tip is often broad, with thick skin and weak tip cartilages, and standard techniques can disappoint. The author presents his approach to the tip in these patients, based on two decades of practice in Turkey.

Sections of note

Personal series of 3,800 rhinoplasty patients with broad noses over 20 years.
Tip graft: diced cartilage wrapped in Surgicel (the Turkish delight graft), combined with a columellar strut.
The author reports considerably improved results, the desired tip form, and elimination of late graft show.
In patients with very short columellae, a second strut was needed after 1 year.
Described as safe, reliable, effective, simple and applicable by surgeons at all experience levels; early and late results very satisfactory.
No late show as seen with crushed, oval or rectangular solid grafts.
The abstract gives no satisfaction scores, complication rates or revision rates; level of evidence: therapeutic, IV.

What it means for a patient

Thick-skinned broad tips are shaped here by adding soft, moldable cartilage rather than a solid piece that can later show through.
A very short columella may need a second support operation about a year later.
One surgeon's assessment of a very large series; no comparison group and no numbers on outcomes.

Why this paper matters

Erol's Turkish delight graft is one of the most cited techniques in Middle Eastern rhinoplasty, though Surgicel wrapping was later linked by others to resorption. This paper extends the graft from the dorsum to the tip. Measured outcomes are absent.

Terms

Diced cartilage: cartilage cut into tiny cubes so it can be molded.
Surgicel: an absorbable oxidized cellulose gauze used to wrap the diced cartilage.
Turkish delight graft: the author's name for diced cartilage wrapped in Surgicel.
Columellar strut: a cartilage rod between the tip cartilages that supports the tip.
Late show: a graft becoming visible through the skin months or years after surgery.
Lower lateral cartilages: the paired tip cartilages that shape the tip and nostrils.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Historically, one of the most persistent challenges to the rhinoplasty surgeon has been the thick, heavy, and poorly defined nasal tip. In the Mediterranean, Anatolian, and Middle Eastern regions, rhinoplasty is the most frequently performed aesthetic procedure. In these regions, the ethnic characteristic of the nasal…”

Excerpt; the full abstract is on PubMed.