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Surgical Pearls |

The “Chef’s Knife” in Oblique Split Technique for Rhinoplasty

Fazil Apaydin, MD1
[+] Author Affiliations
1Department of Otolaryngology, Ege University Medical Faculty, İzmir, Turkey
JAMA Facial Plast Surg. 2015;17(5):382-383. doi:10.1001/jamafacial.2015.0332.
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The author testifies that a general utility surgical “chef’s knife” should be part of the surgical set when the use of costal cartilage is an option for the patient.

In cooking, a chef’s knife (cook’s knife) is a cutting tool used in food preparation. It is the primary general utility knife for most Western cooks.1 In saddle noses, revision cases, and some traumatic cases, I have been using costal cartilages (fifth through ninth) for 16 years, and I was constantly in search of the surgical equivalent of a chef’s knife to sculpture costal cartilage. Until 6 years ago, I used to take the middle part of the cartilage to prevent warping and also used 2- to 3-mm-thick grafts. Then, in 2009, I learned the oblique split technique from Eren Tastan, MD, at the Second Annual Meeting of the Turkish Society of Facial Plastic Surgery.2 Thereafter, it became the technique I most often use in obtaining grafts from costal cartilages for the following reasons:

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Figure 1.
Feather F-130 Trimming Handle and Blade

The handle is 26 cm long with a metallic guide of 13.5 cm. The 130-cm-long disposable blade is fixed in the housing with a bolt. Although the height of the blade is 18 mm, after inserting it to the metallic housing, the cutting height becomes 7 mm, which is ideal for cutting the costal cartilages that are 5 to 8 mm in height.

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Figure 2.
Using the “Chef’s Knife” to Cut Implants

In addition to implants of various thicknesses, paper thin implants can also be cut by this knife to use for camouflage.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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