Cartilage putty: a novel use of fibrin glue with morselised cartilage grafts for rhinoplasty surgery.

Cartilage grafts have multiple purposes within rhinoplasty surgery. The senior author has previously used wrapped diced cartilage grafts but found it difficult to maintain the integrity of the graft "package" during placement. Introduction of Tisseel fibrin glue stabilises the cartilage fragments producing a rubbery mass that can be used like "cartilage putty." This malleable construct can be inserted and moulded with less risk of dispersal. This technique has now been used on nineteen patients. It has provided a valuable method of reconstruction especially in complex cases such as revision rhinoplasty and patients with a thin dorsal skin envelope. There has been no evidence of graft absorption or requirement for additional surgery to date. The addition of Tisseel to wrapped diced cartilage grafts, has proven in this series of complex rhinoplasty patients, to be a useful adjunct which aids insertion and contouring. Furthermore, beneficial effects on healing have been demonstrated which contributes to good quality long-term cosmetic results. Level of Evidence V.