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Sep
1st
Lend Me An Ear: Ear cartilage alar batten grafts

Thomas Lamperti

See where harvested ear cartilage comes from, what it looks like and how it is carved to become an alar batten graft.


In prior posts I've discussed the surgical approach treating nasal valve collapse. Often, I'll use septal cartilage to make batten grafts, but in situations in which a patient has had a prior septoplasty or if many grafts need to be used during the rhinoplasty ear cartilage can be used.


What part of the ear does a conchal cartilage ear graft come from?

As the name implies, conchal ear cartilage grafts come from the curved conchal cartilage of the external ear. The photo below shows the two areas of the external ear where cartilage can be harvested from.



The larger, lower area is usually the first choice of where to harvest cartilage from. If additional cartilage is need the smaller upper area can also be used. If even more cartilage is needed the opposite ear can also be used.


Where Is The Incision Placed To Harvest Conchal Cartilage?

Surgeons can harvest ear cartilage using either an incision placed behind the ear or in front of the ear (placed on the anti-helical rim). I typically use a post-auricular approach as this hides the incision very nicely.

 

Does Harvesting Conchal Cartilage Change the Ear Shape?

Many people are concerned that removing cartilage from their ear will change the ear's shape. In general, the ear should maintain it's normal shape after surgery. In rare instances the ear may become more setback after surgery. Once the ear cartilage is removed, the overlying skin is left in place. I then suture the anterior and posterior skin to each other using a dissolvable quilting suture.


What Does Harvested Conchal Cartilage Look Like?

So what does harvested ear cartilage look like? This photo shows two portions of ear cartilage that will be carved into alar batten grafts.



Where are conchal cartilage grafts placed as alar batten grafts?

So where do we place the cartilage grafts once we've harvested them and carved them into the proper shape? This photograph shows what the carved batten graft look like and also which area it is ultimately placed. Using either an open or closed rhinoplasty approach the graft can be placed under the skin in this area to support and strengthen a weakened external nasal valve.



Will a batten graft make my nose bigger?

Batten grafts are made of rather thin cartilage and are place under the thick skin of the nasal sidewall and tip. Ultimately, the grafts should not make the nose any bigger, though it may correct any existing pinching in the area. It is normal to be able to feel the cartilage somewhat if you pinch that part of your nose (just like how you can feel the normal cartilage of your tip).


Related Seattle Rhinoplasty Blog Posts:

Added on 09/01/2012

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rhinoplasty by Blog

 

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