Perichondrial Attached Diced Cartilage (PADC), a Novel Graft Material for Nasal Augmentation: 10 Years of Experience

Background Using onlay graft for dorsal augmentation is a challenging procedure. Visibility and warping of grafted cartilages can ruin an otherwise successful operation. A shortage of septal cartilage and rib donor site morbidity compounds the problems of this procedure. Objectives Our objectives were to find an autologous material for dorsal nasal augmentation which does not disperse upon implementation. It also should have minimal resorption, lack of warping and no need for wrapping membrane. Methods In 30 patients, concha cartilage of the ear with attached perichondrium and fascia were removed. The concha cartilage was diced while it was attached to the posterior soft tissue. The purpose was to develop graft material for dorsal augmentation. Results In an average of 19.56 months follow-up, no sign of resorption, infection, inflammation, volume loss, or displacement of the grafted material was noticed. Aesthetically the results were acceptable and most of the patients were satisfied with the outcome. Conclusions Perichondrial attached diced cartilage (PADC) is a new material for the rhinoplasty surgeon to apply in different onlay nasal augmentation procedures in the unduly reduced nasal dorsum. This technique transforms an uneven peculiar-shaped concha cartilage to flexible, versatile, and durable material. The donor site is in the surgical field and easy to access.