Evaluation of A Well-Known Technique with Ultrasound: Dorsal Grafting in Rhinoplasty

Overview

The Turkish delight technique packs leftover septal cartilage pieces into a soft graft used to smooth the bridge. This retrospective study used ultrasound to track how much thickness the graft actually contributed over time, measuring at set intervals through the first postoperative year.

Sections of note

• 22 patients, 8 women and 14 men, all operated by the same surgeon in Isparta, Turkey, between December 2013 and February 2015.
• Graft material was leftover harvested septal cartilage mixed with venous blood as a scaffold, in a Turkish delight fashion.
• Imaging used a 10 to 14 MHz broadband linear ultrasound probe; mean total skin thickness was calculated over bone at the dorsum and over cartilage at the upper lateral cartilage.
• Measurements were taken preoperatively and at day 7, month 1, month 6, and just before the end of the first year, all at the same time of day to exclude daily variation in skin swelling.
• Dorsal thickness was significantly greater on day 7 but not significantly different from baseline at 6 months.
• Supratip thickness was significantly greater at day 7, with a large but non-significant difference at 1 month, and no significant difference at 6 months.
• Level of evidence IV.

What it means for a patient

• The added thickness measured early was largely swelling, not lasting graft volume.
• The authors conclude the technique can smooth visible and palpable irregularities and refine the bridge line, but is not sufficient for building the bridge up.
• Limits: 22 patients, one surgeon, retrospective, no comparison group, and ultrasound measures total thickness rather than the graft itself.
• The abstract reports no cosmetic or satisfaction outcomes.

Why this paper matters

Camouflage grafts are widely used on the assumption that they persist, and this measures rather than assumes. The finding separates smoothing from augmentation as two different goals. The small sample and lack of a control group limit how far the conclusion carries.

Terms

• Dorsal graft: Material placed on the bridge of the nose to smooth or build it up.
• Turkish delight: A technique using cartilage fragments in a soft mass as a camouflage graft.
• Supratip: The area of the nose just above the tip.
• Scaffold: A material holding graft fragments together in place.
• Ultrasonography: Imaging using sound waves, here to measure tissue thickness.