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The Versatile Posterior Auricular Fascia in Secondary Rhinoplasty Procedures

Abstract

Background

Secondary rhinoplasty often involves the addition of autogenous graft material to add volume, structure, support and to camouflage cartilage and bone grafts. A variety of fascias have been used to camouflage, wrap and give “fill” in secondary rhinoplasty. The posterior auricular fascia is a source of material ideal for such purposes, and its quantity, anatomical structure and ease of harvest with minimal donor site morbidity make it a versatile and attractive autogenous graft.

Methods

The clinical records of patients receiving autogenous posterior auricular fascial grafts were reviewed. There were two main uses of this graft material, one was to cover the tip reconstruction in secondary rhinoplasties under thin tip skin. This is a camouflage graft. The second use is for fill and augmentation, especially for the nasal dorsum and as an interpostitional graft between the dorsum and the tip.

Conclusion

The posterior auricular fascial graft has many potential uses in secondary rhinoplasties and is readily harvested as a generous graft concurrent to conchal cartilage harvest and with a concealed scar behind the ear.

Level of Evidence V

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Author information

Correspondence to Darryl James Hodgkinson.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Informed Consent

All persons involved in this study have given informed consent for their images to be used for scientific or educational purposes. Informed consent was given by the patients for the publication of their case reports.

Ethical Approval

All surgical procedures were performed in the authors’ private practice and were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MP4 14410 kb) Posterior auricular fascia elevated from behind the concha and posterior to the auriculocephalic sulcus

Video 1

Supplementary material 1 (MP4 14410 kb) Posterior auricular fascia elevated from behind the concha and posterior to the auriculocephalic sulcus

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Hodgkinson, D.J., Valente, P.M. The Versatile Posterior Auricular Fascia in Secondary Rhinoplasty Procedures. Aesth Plast Surg 41, 893–897 (2017) doi:10.1007/s00266-017-0824-0

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Keywords

  • Posterior auricular fascia
  • Secondary rhinoplasty
  • Tip camouflage