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

OBJECTIVES/HYPOTHESIS: 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.

STUDY DESIGN: A retrospective clinical chart review.

METHODS: 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.

RESULTS: 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).

CONCLUSIONS: 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.