Abstract
Fascia is frequently used in rhinoplasty, for several different purposes. The deep temporalis fascia is most often chosen, though harvesting this fascia requires a separate surgical field that adds surgical time to the procedure and morbidity to the patient. In augmentation rhinoplasty cases as well as in many revision rhinoplasty cases, costal cartilage may be required. In these cases, when costal cartilage is harvested from the 5th to 7th ribs, pectoralis major fascia is in the surgical field and must be incised to provide access to the costal cartilage. Pectoralis major fascia is similar to the deep temporalis fascia, sharing many physical and histological characteristics with it. Pectoralis major fascia can be harvested from the same surgical field as costal cartilage and used in the nose whenever autologous costal cartilage is harvested, thus precluding the need for a separate surgical field for fascia harvest. The surgical technique for harvesting pectoralis major fascia is demonstrated, and two clinical cases of patients in whom this fascia was harvested and used in the nose are presented. Pectoralis major fascia may be considered an alternative option for use in rhinoplasty cases whenever autologous costal cartilage is used.
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References
Daniel RK, Sajadian A (2012) Secondary rhinoplasty: management of the overresected dorsum. Facial Plastic Surg 28(4):417–426
Karaaltin MV, Batioglu-Karaaltin A, Orhan KS, Demirel T, Guldiken Y (2012) Autologous fascia lata graft for contour restoration and camouflage in tertiary rhinoplasty. J Craniofac Surg 23(3):719–723
Karaaltin MV, Orhan KS, Demirel T (2009) Fascia lata graft for nasal dorsal contouring in rhinoplasty. J Plast Reconstr Aesthet Surg 62(10):1255–1260
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(4):528–532
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(1):88–92
Findley T, Chaudhry H, Stecco A, Roman M (2012) Fascia research—A narrative review. J Bodyw Mov Ther 16(1):67–75
Stecco A, Masiero S, Macchi V, Stecco C, Porzionato A, de Caro R (2009) The pectoral fáscia: anatomical and histological study. J Bodyw Mov Ther 13(3):255–261
Jinde L, Jianliang S, Xiaoping C, Xiaoyan T, Jiaqing L, Qun M, Bo L (2006) Anatomy and clinical significance of pectoral fascia. Plast Reconstr Surgery 118(7):1557–1560
Dalberg K, Johansson H, Signomklao T, Rutqvist LE, Bergkvist L, Liljegren G, Ambre T, Sandelin K (2004) A randomised study of axillary drainage and pectoral fáscia preservation after mastectomy for breast câncer. Eur J Surg Oncol 30(6):602–609
Spiess AM, Balakrishnan C, Gursel E (2007) Fascial release of the pectoralis major: a technique used in pectoralis major muscle closure of the mediastinum in cases of mediastinitis. Plast Reconstr Surg 119(2):573–577
Gao JH, Ogawa R, Hyakusoku H, Lu F, Hu ZQ, Jiang P, Yang L, Feng C (2007) Reconstruction of the face and neck scar contractures using staged transfer of expanded “Super-thin flaps”. Burns 33(6):760–763
Louis RG, Tubbs RS, Mortazavi MM, Shoja MM, Loukas M, Cohen-Gadol AA (2013) Harvest of autologous clavipectoral fáscia for use in duraplasty: cadaveric feasibility study. J Craniofac Surg 24(2):619–621
Erol OO (2000) The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 105(6):2229–2241
Daniel RK, Calvert JW (2004) Diced cartilages grafts in rhinoplasty surgery. Plast Reconstr Surg 113(7):2156–2171
Calvert JW, Brenner K, DaCosta M, Evans GR, Daniel RK (2006) Histological analysis of human diced cartilages grafts. Plast Reconst Surg 118(1):230–236
Vasani SS, Anmolsingh R, Kwame I, East C (2014) A single incision for harvesting conchal cartilage and temporalis fáscia in diced cartilage-fascia grafts. Jama Facial Plastic Surg 16(5):374
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Xavier, R. Pectoralis Major Fascia in Rhinoplasty. Aesth Plast Surg 39, 300–305 (2015). https://doi.org/10.1007/s00266-015-0461-4
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DOI: https://doi.org/10.1007/s00266-015-0461-4