Premaxillary augmentation using autologous costal cartilage as an adjunct to rhinoplasty

Premaxillary augmentation is a widely adopted procedure used as an independent facial contouring operation or as an adjunct to rhinoplasty. Insufficient projection of the praemaxilla is a relatively common deformity, especially in the Asian population. We performed two cases of premaxillary augmentation using autologous costal cartilage as an adjunct to rhinoplasty. The first case was a 17-year-old man, who had had an underprojected and over-rotated nose with a bulbous tip since birth. He underwent bilateral premaxillary augmentation using autologous costal cartilage and a rhinoplasty with unilateral extended spreader graft in conjunction with columella strut insertion and dorsal augmentation with Goretex. The second case was a 22-year-old male, who had a repaired left cleft lip and palate. He underwent a revision unilateral premaxillary augmentation and rhinoplasty with columella strut insertion, nasal tip cap graft and dorsal augmentation using autologous costal cartilage. The two patients were satisfied with the results of both the premaxillary augmentations and the rhinoplasties. In both patients, we performed a correction of the acute nasolabial angle and the midface was augmented, which resulted in a more pronounced nasal tip augmentation and a more natural appearance of the midface. We suggest that autologous costal cartilage block could be satisfactory graft material for premaxillary augmentation. (C) 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.