ABSTRACT SECTION OF PROF. DR. ONUR EROL’S LATEST ARTICLES ON THE NOSE, PUBLISHED IN THE WORLD’S MOST PRESTIGIOUS PLASTIC SURGERY JOURNAL

LONG-TERM RESULTS AND REFINEMENT OF THE TURKISH DELIGHT TECHNIQUE FOR PRIMARY AND SECONDARY RHINOPLASTY: 25 YEARS OF EXPERIENCE

LONG-TERM RESULTS OF THE TURKISH DELIGHT TECHNIQUE IN PRIMARY AND SECONDARY RHINOPLASTY WITH 25 YEARS OF EXPERIENCE

Ö. ONUR EROL

Plast Reconstr Surg 2016; 137(2): 423-437.

ABSTRACT
All cartilage grafts have potential problems such as late-stage prominence, displacement, and sometimes resorption. In 1989, Dr. Onur EROL first introduced the use of diced cartilage wrapped in Surgicel (oxidized lyophilized cellulose) to eliminate these problems and achieve a smooth contour. It is known that nasal edema in patients resolves by 90-95% within one year following surgery.
Methods: The author presents his experiences over the last 25 years, treating 9398 primary and secondary rhinoplasty patients with his self-developed ‘Turkish Delight’ technique.

Findings: When Turkish Delight-type cartilage tissue (diced cartilage wrapped in Surgicel) is used, complications such as protrusion of the cartilage from under the skin, which are seen after other nasal tip cartilage augmentation techniques, do not occur in the late period. The long-term results of this technique, ranging from 4 to 25 years, are very satisfactory, and the complication rate is quite low.

Conclusions: This technique is safe, reliable, effective, simple, and can be easily applied by plastic surgeons of all experience levels. Early and late results between 1 and 25 years are satisfactory. The overall complication rate is quite low compared to other techniques. Furthermore, late-stage cartilage protrusion, sometimes seen with other types of cartilage tissues using crushed, oval, or quadrangular cartilage structures, is not observed with this technique.
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INJECTION OF COMPRESSED DICED CARTILAGE IN THE CORRECTION OF SECONDARY AND PRIMARY RHINOPLASTY: A NEW TECHNIQUE WITH 12 YEARS’ EXPERIENCE

Ö. ONUR EROL

Plast Reconstr Surg 2017; 140(5): 1-13.

INJECTION OF COMPRESSED AND DICED CARTILAGE IN PRIMARY AND SECONDARY RHINOPLASTY: A NEW TECHNIQUE WITH 12 YEARS’ EXPERIENCE

There are cases where small or large defects in the nose are filled with diced cartilage without being wrapped in any material. For this purpose, 1-cc commercial syringes are used. The results remain partial and incomplete. For better and more successful results, Dr. ONUR EROL designed new injectors of two different sizes that compress diced cartilage.

Methods: The author presents his experience using the new syringe design in 2366 primary and 749 secondary rhinoplasty patients, and 67 cases of cleft lip and nasal deformity, out of a total of 3182 rhinoplasty patients treated over the last 12 years. The cartilage syringe compresses the diced cartilage, making it cohesive and injectable as a moldable structure resembling rib cartilage.

Findings: In 3125 patients, the cartilage graft took completely (98.2%), providing a smooth surface with a natural appearance. Partial resorption of cartilage was observed in only 21 patients (0.65%). In revision surgery for these patients, correction was achieved by injecting a small amount of diced cartilage. In 36 patients (1.13%), a nasal contour requiring rasping correction developed after 1 year.

Conclusions: Compared to diced cartilage wrapped with Surgicel or fascia tissue, the amount of injected cartilage tissue was predictable because it consisted entirely of cartilage. Since the injected diced cartilage is compressed and cohesive, it resembles a piece of wood or carved rib cartilage. It is superior to carved cartilage due to its moldability, time-saving nature, and the absence of late-stage cartilage protrusion or warping. The injection takes only a few minutes.

TIP RHINOPLASTY IN BROAD NOSES IN A TURKISH POPULATION: EURASIAN NOSES
Ö. ONUR EROL

Plastic Reconstructive Surgery, 2012; 130: 185-197.

TIP RHINOPLASTY IN BROAD NOSES IN TURKISH PATIENTS: EURASIAN NOSES

ABSTRACT
For years, the most challenging cases for plastic surgeons in nasal surgery have been heavy, thick, and poorly shaped nasal tips. In individuals living in the Mediterranean, Anatolian, and Middle Eastern regions, rhinoplasty is the most common aesthetic surgery. The nasal tips of people in this region typically have broad and thick skin, are poorly shaped, and have weak lower cartilages. These ethnic characteristics make it difficult to achieve an aesthetic shape for the nasal tip. In these patients, standard nasal surgery techniques may not satisfy both patients and surgeons.

Method: The author presents his personal approach experience used in operating on 3800 rhinoplasty patients with broad noses over the past 20 years.

Using ‘Turkish Delight’ type cartilage grafts for the nasal tip increased the success of the results, provided a desired beautiful shape to the nasal tip, and eliminated the problem of cartilage tip protrusion seen in other nasal tip cartilage techniques. In these patients with very short columellas, a second supporting cartilage graft is necessary one year after the initial surgery.

Conclusion: The Turkish Delight technique is a safe, reliable, effective, simple method that can be easily applied by plastic surgeons of all experience levels. Early and late results are very satisfactory.
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MICROFAT GRAFTING IN NASAL SURGERY
Ö. ONUR EROL

Aesthetic Surgery Journal, 2014; 34(5): 671-686.

MICROFAT GRAFTING IN NASAL SURGERY

Fillers are sometimes necessary to correct minor skin irregularities. However, results showing tissue death have been obtained after the injection of laboratory-produced synthetic materials and heterogeneous tissues. It is a well-known fact that autologous fat tissue is more advantageous than these fillers. Augmenting volume and shape with the injection of autologous fat tissue is a popular, reliable, and proven long-term successful method.

Objective: The author presents his study on the injection of autologous fat tissue under the nasal skin in patients with secondary nasal deformities (requiring some corrections with a second surgery after the initial nasal surgery).

Over a 5-year period, 313 patients with nasal deformities such as minor nasal skin irregularities or severe nasal skin damage treated with microfat injections are presented. During each patient’s initial injection period, excess fat tissue harvested was stored using special cold storage methods (-196 °C frozen and -83 °C stored) for use in subsequent injections. 0.3-0.8 ml of microfat graft was used to correct small deformities, and 1-6 ml for large nasal deformities or skin irregularities in each treatment session.

Findings: Satisfactory results were obtained in all patients with simple deformities with 1 to 3 microfat injections. For patients with severe irregularities, 3-6 sessions of microfat injection were necessary, resulting in high patient satisfaction. In another group of patients with severe traumatic nasal skin damage, 6-16 sessions of microfat injection were required for reconstruction. Skin damage in each patient improved with repeated injections.

Conclusions: Corrections made by injecting autologous fat tissue to correct minor irregularities of the nose appear to be a safe and effective technique. Furthermore, it is very beneficial in correcting damaged skin and preparing it healthily for a new surgery.