Plumping grafts may he used to open up an acute nasolabial angle, improve a retracted columella, and support a deficient nasal base. Dissect a midcolumellar precise pocket to just above the nasal spine. Place multiple small pieces of cartilage (I mm to 2 mm), harvested from the septum or ear, in the pocket. These grafts will augment the deficient area (Fig. 1) (1,2). Plumping grafts placed below the medial crural footplates will increase sup-port of the nasal base (Appendix F)

Figure 1. Plumping grafts may improve a retracted columella.