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Graft selection
Graft selection
Antihelical and conchal bowl cartilages are both commonly used for repairs in dermatologic surgery. Conchal bowl cartilage is typically used when a larger piece of cartilage is required for repair of the nasal ala, columella, septal cartilage, or the crura
of the lower nasal cartilage.30 Although crural cartilage is an option for cartilage and soft tissue reconstruction, cartilage of the antihelix is usually sufficient in dermatologic surgery.
The cartilage of the antihelix is more elastic, less brittle, and has a greater innate curve than that of the concha, which generally makes it a more favorable option when a cartilage graft is required along an anatomic structure with natural curvature such as the helical rim or nasal ala.31 The antihelix is also easily accessible, and once the cartilage strip is harvested, the tension-free donor site can be closed primarily leaving a resulting scar that is almost imperceptible. Although typically cartilage grafts are covered with either a local flap or an FTSG, a cartilage alar batten graft alone may be sufficient in select patients for alar reconstruction with acceptable functional and aesthetic outcomes.32