Multilayer tutoplast-processed fascia lata use in revision rhinoplasty for overresected dorsum

Abstract

Several grafting materials have been used in revision rhinoplasty to correct overresected dorsum. Autologous materials are generally preferred, but have the drawbacks of additional surgical time and donor site morbidity. Tutoplast-processed fascia lata (TPFL) offers a commercially available alternative to autologous fascia grafts. We reviewed the results of 42 revision rhinoplasty procedures that used TPFL with or without autologous cartilage to correct overresected dorsum. Forty-two patients with overresected dorsum underwent revision rhinoplasty with multilayered TPFL at our institution between 2005 and 2012. Saddle nose deformities were classified into one of three types, according to severity. Surgical results were evaluated as excellent, good, or fair by an otolaryngologist who compared preoperative photographs with pictures taken at final follow-up. Surgical complications were analyzed. Of the 42 patients who underwent rhinoplasty with multilayered TPFL, 36 were treated with TPFL alone, while autologous cartilage was used concurrently in six. Twenty-six (62 %) of the patients showed excellent aesthetic improvement, 11 (26 %) showed good improvement, and five (12 %) showed fair improvement. There were no major complications. Minor complications included edema in six patients, major resorption in three, and minimal resorption in nine. Patients with mild or moderate saddle nose deformity had better surgical results than those with more severe deformity. There are many possible methods to correct overresected dorsum. Multilayer TPFL is safe alternative to autologous rib cartilage grafts. Level of Evidence: Level IV, therapeutic study.