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Page 4 of 10 Rajbhandari et al. Plast Aesthet Res 2019;6:8 I http://dx.doi.org/10.20517/2347-9264.2018.86
A B
Figure 3. A: Oblique linear sutured wound about 2 cm over right inframammary fold after rib cartilage harvesting; B: a linear scar,
appearing almost invisible, one year after surgery
A B
Figure 4. A: Intraoperative measurement of profile heights at nasion, bridge at mid-pupil level, rhinion and nasal tip; B: a paper is cut to
check the nasolabial angle before and after surgery
Figure 5. Fusiform shaped carved rib cartilage, perichondrium is placed on the cephalic end of the onlay graft to smoothen the radix contour
INTRAOPERATIVE MEASUREMENT
Before we carve the rib, we measure the height of the nose at 4 points in order to monitor the profile change
during the operation [Figure 4] and check the contour change: (1) nasion height from the medial canthus; (2)
bridge height at mid-pupil level; (3) rhinion; (4) nasal tip.
The shape we carve the rib graft into can be best described as a “fusiform” shape. It is tapered off on both
ends and has a wider mid region [Figures 5-9]. We use the longer portion of the harvested costal cartilage
for dorsal augmentation and the remaining shorter portion for other grafts (splint grafts, lateral crura strut
