Combined use of crushed cartilage and processed fascia lata for dorsal augmentation in rhinoplasty for Asians

Abstract

Autologous dorsal nasal grafts have limitations including limited tissue availability, additional surgery time, donor site morbidity, a visible graft contour, and postoperative distortions and deformities owing to displacement and warping. This report describes our experience using combined Tutoplast-processed fascia lata (TPFL) and crushed cartilage for dorsal augmentation and contouring in rhinoplasty. A retrospective clinical chart review. The study involved a total of 113 patients (68 male, 45 female), who underwent crushed cartilage-TPFL grafting to the nasal dorsum. Patient satisfaction was evaluated using a questionnaire. Photographs and postoperative histories were reviewed to assess complications including graft resorption, graft infection, warping, extrusion, irregularity, and postoperative deformity. Different autologous grafts were used in combination with TPFL: septal cartilage in 70 cases (61.9%), septal cartilage and ethmoid bone in 17 cases (15.0%), costal cartilage in 15 cases (13.3%), and septal and conchal cartilage in 11 cases (9.7%). Of the 101 patients who responded to the questionnaire, 85.1% were satisfied with the surgical outcome. Complications were encountered in four patients (3.5%), comprising overcorrected dorsal augmentation in two patients, graft resorption in one patient, and dorsal irregularity in one patient. Eight patients (7.1%) required revision rhinoplasty due to dissatisfaction with the nasal tip shape (n = 6), graft resorption (n = 1) and overcorrected dorsal augmentation (n = 1). The combined use of crushed cartilage and TPFL appears to be a useful technique for dorsal augmentation and contouring. This technique provides favorable and predictable outcomes in rhinoplasty. Laryngoscope, 2009.