A New nose tip-defining technique for asians using autologous cartilage prefabricated with octyl-2-cyanoacrylate adhesive

Objectives: To form and test a prefabricated, 3-dimensional tip graft structure from autologous cartilage pieces and octyl-2-cyanoacrylate adhesive (Dermabond). Displacement and instability of grafted cartilage are common drawbacks of endonasal tip surgery, and we evaluated the feasibility and efficacy of octyl-2-cyanoacrylate adhesive for clinical use. Methods: Three New Zealand rabbits were examined in this study. We cut auricular cartilage into pieces of approximately 1 × 2 cm and glued them together with octyl-2-cyanoacrylate. Three months after subcutaneous implantation in the rabbits, we histopathologically analyzed foreign body reactions, histotoxic effects, and the structure of the regenerative tissue in the implanted cartilage. Furthermore, from human patients we harvested small pieces of autologous cartilage and cemented them together with octyl-2-cyanoacrylate adhesive to prefabricate 3-dimensional tip grafts, which we then inserted into the nasal tips of patients via an endonasal approach to project and contour the nasal tip. The changes in tip definition of 42 Asian patients were analyzed. Results: Octyl-2-cyanoacrylate adhesive interacts well with cartilage tissues with no systemic or local adverse effects. Its ability to bond cartilage instantaneously allows for the fabrication of intricate cartilage implant components. The aesthetic results in 42 cases were excellent, and the implants were both safe and effective. Conclusion: Our results demonstrate that octyl-2-cyanoacrylate can be safely used in endonasal tip surgery to produce excellent cosmetic outcomes in Asian subjects.