Can Injectable Cartilage Be Used For Premaxillary-Paranasal Augmentation?
Q: Dr. Eppley, do you do injectable cartilage? Can this be used to give support in the nostril sill area? My sills were partially removed from a bullhorn lip lift and I thought the cartilage injections might rebuild the area. Dr. Onor Emrol in Istanbul says the injectable cartilage can be used in this area but I can’t really travel that far and he doesn’t do phone consults. I have scarring at the base of the nose loss of nostril support from the liplift and the sills were partially removed due to where the incision was placed. Also can the injectable cartilage be used to do premaxillary augmentation. I want to move forward the nasolabial angle. The nasolabial angle is now caved in due to being scarred down from the liplift and I need to increase the angle push it away from my face.
A: I have done numerous diced cartilage grafts, whether it is by injection or with a rolled graft fabrication in fascia or surgicel collagen material. The key questions are whether such cartilage grafts will work for your two indications and what volume is needed. From a premaxillary/paranasal augmentation standpoint, the issue with using cartilage is the volume of donor material needed. The septum will not have enough material to create enough push to make a visible difference in these areas. To get good volume, a lower rib donor source is needed where a good bloc can be removed and used. Whether one dices up the cartilage or injection below the skin and places it at the bony level in a carved form just like a synthetic paranasal-premaxillary implants is a matter for further discussion. From a nasal sill standpoint, the septum or ear will offer enough material to dice and injected beneath the scarred nasal sill area. While this will not replace lost skin that was removed from the lip lift, it will provide subcutaneous volume to push out on the area.
Dr. Barry Eppley