Nose and Midface Augmentation by Rib Cartilage Grafts: Methods and Outcome in 32 Cases

Recession of the midface is a relatively common condition that can have a negative impact on facial and nasal aesthetic appearance, and it poses a challenge to plastic surgeons. In cases with generalized maxillary retrusion and/or malocclusion, bone advancement surgery is required, but in localized cases, mostly seen in cleft lip patients, the quest is for an ideal material and a proper technique that would be used to augment the receding area. Throughout a period of seven years, thirty-two patients with nose and midface retrusion were managed by a construct of rib cartilage grafts designed to compensate the deficiency at the maxillary, piriform, and premaxillary areas. Results were satisfactory for most patients in terms of improved fullness of malar area, improved nasal tip projection and rotation, and improvement of upper lip. The presented technique of rib cartilage grafting is a safe and effective method for nose and midface augmentation.