ABSTRACT
The need for structural grafting in rhinoplasty arises when the nasal skeletal framework
is weakened, malpositioned, or both. This review will be limited to structural grafting
of the cartilaginous nasal skeleton. Current techniques will be reviewed and a technique
introduced that addresses the common deformity of a superiorly rotated and deprojected
nasal tip complex while simultaneously correcting nasal valve collapse. This technique
is referred to as the Dynamic Adjustable Rotational Tip (DART) technique. The operative
technique of the DART, as well as the basic philosophy regarding the tensile nature
of the cartilaginous nasal skeleton will be described.
KEY WORDS
structural - grafting - rhinoplasty - rotation - projection
