Journal CME Article: Optimizing the Use of Autografts, Allografts, and Alloplastic Materials in Rhinoplasty-Journal CME Article: Optimizing the Use of Autografts, Allografts, and Alloplastic Materials in Rhinoplasty Video 4

Video Transcription

So I'm Dr. Richard Reich, board-certified plastic surgeon. I'm accompanied by our chief resident from Northwell Plastic Surgery, Dr. Kevin Chen,  and we're doing a revision rhinoplasty today. One thing that I always use in revision rhinoplasties is MTF cartilage for all the cartilage grafts. When I do primary rhinoplasty,  we always use septal cartilage for all the grafts. In revisions, we always use MTF cartilage. This is irradiated cadaveric root cartilage. When it comes in the package,  we like to let it thaw for an hour prior to surgery. We leave it in the plastic, and I have one of my assistants hold it in their hand to allow it to thaw quicker.  It will warp ever so slightly, and we will cut the part that's warped. It is extremely important when using MTF cartilage that you allow it to thaw for one full hour  so that you can avoid warping in vivo in the patient. You really wanna let this sit, cut it, therefore you get straight pieces. We'll show you how to do that today.  The most frequent types of grafts that I use MTF cartilage for are rigid structural support grafts, bilateral spreader grafts, bilateral alar contour grafts,  a strong, rigid, polymellar strut graft. Those are the types of grafts we use MTF cartilage for. This is not meant to do as a tip graft. Tip grafts need to be soft cartilage,  lower lateral cartilage, perhaps auricular cartilage, crushed cartilage. We never use MTF for tip grafts, and we'll love to show you how we use this today  in our revision rhinoplasty surgery.

Video Summary

Dr. Richard Reich, a board-certified plastic surgeon, explains his approach to revision rhinoplasty using MTF (irradiated cadaveric root) cartilage for grafts. Unlike primary rhinoplasties, where septal cartilage is used, revisions require MTF cartilage, which must thaw for an hour before surgery to prevent warping. MTF cartilage is suitable for rigid structural support grafts, like spreader and alar contour grafts, but not for tip grafts, which need softer cartilage. Dr. Reich emphasizes careful preparation to ensure straight cartilage pieces, enhancing surgical outcomes for revision rhinoplasty.

Keywords

revision rhinoplasty

MTF cartilage

plastic surgery

graft preparation

Dr. Richard Reich