Reasonable and safe access to the septal cartilage is the basic skill of the surgeon doing comprehensive rhinoplasty; international history for decades; when taken must be more than 1cm from the upper and lower end, it will be completely safe; as for the fear of “weakening” the support is entirely the doctor concerned “play bad As for the concern of “weakening” the support, it is entirely due to the doctor concerned “playing badly” with this international classic method: for example, being too greedy, taking the position too close to the edge, or not grasping the level of the cartilage membrane, peeling perforation, badly growing perforation, etc. In my early years, I also experienced a slight perforation; when I was repairing, it was super difficult to close the small space inside and sometimes it took an hour to get a real stitch. Later, after learning a very practical trick from Dr. Byrd of Dallas, I never had any more piercings. To get enough septum material, you can’t be too greedy (there is often only so much septal cartilage) and you need to be clever and take a little thin but strong sieve bone!
This is the key to my ability to safely make a good nose using only septum-derived tissue ~ the back of the nose is left to other cartilage particles or various prostheses.