Cartilage recycling in rhinoplasty: Polydioxanone foil as an absorbable biomechanical scaffold

Background: Primary and secondary rhinoplasty often requires multiple cartilage grafts. Polydioxanone foil may be used as a temporary biomechanical scaffold on which routinely discarded cartilage fragments can be assembled to make maximal use of harvested material. Methods: The authors performed an outcome analysis of 58 primary and secondary rhinoplasties in which polydioxanone foil was used in combination with autologous cartilage for aesthetic and valvular reconstruction of the nose. Graft performance, complications, and technical points are reported. Results: The temporary scaffold (polydioxanone foil) was used most often to construct columellar struts, septal extension grafts, and alar battens. Other uses included revision septoplasty and upper lateral replacement grafts. Two minor complications occurred: one infection and one partial extrusion. The long-term stability of the nose following this technique was found to be satisfactory (mean follow-up, 18 months), for both structural and aesthetic purposes. Conclusions: This technique is both simple and effective. By making maximal use of otherwise discarded cartilage fragments, it protects other graft harvest sites and decreases the incidence of the "graft-depleted" patient.