Grafts in Endonasal Rhinoplasty

Overview

The author describes rhinoplasty as among the most challenging procedures in facial plastic surgery and states that using grafts appropriately is essential to improving appearance while preserving nasal breathing. He states there is no single best method, but that in his own hands the endonasal approach gave better control of results. The article outlines the surgical points he has developed over his career.

Sections of note

• Technique article written in the first person; the abstract reports no patient numbers, no outcomes and no follow up.
• The stated advantages of the endonasal approach are limiting dissection, using less cartilage and minimizing variables.
• The author explicitly states there is no best method.
• The claimed benefit is greater control over results, framed as his personal experience.
• The article outlines surgical pearls developed across the author's career for executing grafts efficiently.

What it means for a patient

• Endonasal means all incisions are inside the nose, leaving no external scar across the columella.
• Less dissection means less of the nose's supporting tissue is disturbed, which the author links to more predictable healing.
• This is expert opinion with no data, no comparison group and no reported results.

Why this paper matters

The open approach became dominant because it allows direct view and precise graft placement, and endonasal technique persists mainly among experienced surgeons who prefer less disruption. This article records that position and the graft techniques it requires. It offers no evidence comparing the two approaches.

Terms

• Endonasal rhinoplasty: surgery through incisions inside the nose only.
• Graft: a piece of tissue moved from one place to another to support or reshape.
• Dissection: separating tissue layers to expose the structures beneath.
• Nasal function: how well air passes through the nose.
• Surgical pearl: a practical technique tip drawn from experience.