Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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.
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References
Miller TA (1988) Temporalis fascia grafts for facial and nasal contour augmentation. Plast Reconstr Surg 81:524–533
Guerrerosantos J (1984) Temporoparietal free fascia grafts in rhinoplasty. Plast Reconstr Surg 74:465–475
Karaaltin MV, Orhan KS, Demirel T (2009) Fascia lata graft for nasal contouring in rhinoplasty. J Plast Reconstr Aesthet Surg 62:1255–1260
Berghaus A, Stelter K (2006) Alloplastic materials in rhinoplasty. Curr Opin Otolaryngol Head Neck Surg 14:270–277
Tardy ME Jr, Schwartz M, Parras G (1989) Saddle nose deformity: autogenous graft repair. Facial Plast Surg 6:121–134
Toriumi DM (2000) Autogenous grafts are worth the extra time. Arch Otolaryngol Head Neck Surg 126:562–564
Gunter JP, Rohrich RJ (1990) Augmentation rhinoplasty: dorsal onlay grafting using shaped autogenous septal cartilage. Plast Reconstr Surg 86:39–45
Murrell GL (2004) Auricular cartilage grafts and nasal surgery. Laryngoscope 114:2092–2102
Jang YJ, Song HM, Yoon YJ, Sykes JM (2009) Combined use of crushed cartilage and processed fascia lata for dorsal augmentation in rhinoplasty for Asians. Laryngoscope 119:1088–1092
Jang YJ, Wang JH, Sinha V, Song HM, Lee BJ (2007) Tutoplast-processed fascia lata for dorsal augmentation in rhinoplasty. Otolaryngol Head Neck Surg 137:88–92
Jang YJ, Kim JH (2011) Use of tutoplast-processed fascia lata as an onlay graft material for tip surgery in rhinoplasty. Otolaryngol Head Neck Surg 144:528–532
Tarhan E, Cakmak O, Ozdemir BH, Akdogan V, Suren D (2008) Comparison of AlloDerm, fat, fascia, cartilage, and dermal grafts in rabbits. Arch Facial Plast Surg 10:187–193
Brenner KA, McConnell MP, Evans GR, Calvert JW (2006) Survival of diced cartilage grafts: an experimental study. Plast Reconstr Surg 105:105–115
Yu MS, Park HS, Lee HJ, Jang YJ (2012) Histomorphological changes of tutoplast-processed fascia lata in a rabbit rhinoplasty model. Otolaryngol Head Neck Surg 147:239–244
Baker TM, Courtiss EH (1994) Temporalis fascia grafts in open secondary rhinoplasty. Plast Reconstr Surg 93:802–810
Sclafani AP, McCormick SA, Cocker R (2002) Biophysical and microscopic analysis of homologous dermal and fascial materials for facial aesthetic and reconstructive uses. Arch Facial Plast Surg 4:164–171
Acknowledgments
Authors are grateful to Dr. Deniz Hanci ENT surgeon who assessed aesthetic outcomes.
Conflict of interest
Huseyin Altun, Deniz Hanci, Yusuf Can declare that they have no conflict of interest.
Patient consent
Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.
Ethical standards
The study was approved by the Institutional Ethics Committee and conducted in accordance with the Helsinki Declaration.
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Altun, H., Hanci, D. & Can, Y. Multilayer tutoplast-processed fascia lata use in revision rhinoplasty for overresected dorsum. Eur J Plast Surg 38, 279–284 (2015). https://doi.org/10.1007/s00238-015-1082-5
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DOI: https://doi.org/10.1007/s00238-015-1082-5