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Page 6 of 9 Wu et al. Plast Aesthet Res 2019;6:5 I http://dx.doi.org/10.20517/2347-9264.2018.74
Figure 7. Precise placement of corset sutures allows for the creation of dorsal aesthetic lines
A B
C D
Figure 8. (A, C) Frontal, oblique and (B, D) lateral views of Patient 1 before and 2.5 years after primary rhinoplasty with rib cartilage and
diced cartilage fascia
Casting is the last step and is critical for a successful result. The shape and position of the mid-portion of the
graft relies heavily on precise molding and contouring of the cast to shape the coagulum of diced cartilage
within the DCF. For this reason, casting with a thermoplastic splint is recommended to allow for precise
shaping. Once the ideal shape has been obtained, ice-cold water is poured liberally on the cast to lock in
the final shape. The cast and percutaneous sutures are removed 1 week post-operatively. Case examples of
primary and revision rhinoplasties using the updated dice cartilage technique are demonstrated in Figures
8-10, respectively. The dorsum will initially be much wider and taller, but the majority of the swelling will
resolve in 3-6 months with the final results in 1-2 years.
