The hammer graft: A novel technique to provide dorsal support, tip projection, and rotation in rhinoplasty

Background: There are numerous cartilaginous grafts that can be used in rhinoplasty, depending on the specific needs of the patient. These include spreader grafts, dorsal onlay, tip grafts, septal extension, and columellar struts grafts, among others. Objective: The aim of this study is to demonstrate use of the hammer graft in rhinoplasty; this technique can be used to improve dorsal support, tip projection, and tip rotation using a single cartilage graft. Materials and methods: This novel graft was applied in 18 patients who underwent rhinoplasty. In revision patients, hammer graft was harvested from costal cartilage and in primary cases from septum cartilage. They were followed in average 12 months (between 6 and 18 months). Result: Three of these patients were revision cases and 15 were primary cases. In revision patients, hammer graft was harvested from costal cartilage and in primary cases from septal cartilage. The targeted results were achieved to a large extent in all patients. All patients had satisfactory esthetic results. Conclusion: The hammer graft as a single and stable graft useful support for the dorsal part, caudal part and extension part of the septum to be used in primary and revision rhinoplasty.