nasomaxillary reconstruction in binder syndrome bone versus cartilage grafts a longterm intercenter comparison between sweden and mexico maxillonasal dysplasia is characterized by a concave facial profile and a flat nose the etiology of binder syndrome is skeletal hypoplasia around the piriform aperture and excavationsfossae prenasales bilaterally in the nasal floorwhich are pathognomonic there is no real shortage of the soft tissues in 2 medical centers in sweden and mexico different grafts were used for reconstruction but the focus was similar filling out the maxilla anterior to the nasal floor and supporting the nasal framework to normalize tip projection the basis for this study was to compare the longterm results between bone grafts in sweden and cartilage grafts in mexico sixteen patients from both groups were available for longterm followup simplified digital analysis of anthropometric variables were performed in the shortterm and longterm followups the swedish group had primary at the mean age of 213 years whereas mean followup period was 168 years later the mexican group had primary at the age of 136 years and the followup period was 84 years secondary correction was necessary in 25 of the patients in the bone graft group sweden and in 19 of patients in the cartilage group mexico bone grafts slightly relapsed in tip projection and remodeled to some extent in the nasolabial angle cartilage grafts showed stability in the tip projection quotients and resulted in a postoperative normalization of the nasolabial angle but developed a slight relapse between the shortterm and longterm followups both techniques were stable in nose tiplength ratio and a normalization of anthropometric variables was demonstrated in all the longterm followups both the bone and cartilage graft techniques at the 2 centers rendered the intended result of an increased and normalized angle of convexity of the face and nasal tip projection an experience in the properties and behavior of either graft is necessary to get a longterm stable outcome