Diced Cartilage Grafts Wrapped in Rectus Abdominis Fascia for Nasal Dorsum Augmentation

Abstract Background Camouflage of nasal dorsum, aesthetic augmentation and highlighting the dorsal aesthetic lines are essential elements in modern rhinoplasty. Numerous techniques have been utilized including deep temporal fascia, rectus abdominis fascia, and diced cartilage in fascia (DC-F). Despite their wide spread adoption, technical challenges remained, especially when utilized for aesthetic purposes. Objectives The paper details the use of fascia (F) and diced cartilage in fascia grafts (DC-F) for aesthetic dorsal refinement in primary and secondary cases. One of the main goals was to achieve ideal dorsal aesthetic dorsal lines rather than just volume augmentation. Methods We used grafts from the deep temporalis fascia (F) and rectus abdominis fascia (RF) in 4 configurations: 1) single layer, 2) double layer, 3) full length diced cartilage in fascia grafts (DC-F), and 4) partially filled – segmental DC-F grafts. Technical refinements included careful determination of dimensions and meticulously suturing to the dorsum at appropriately 10 points to prevent graft displacement. Results We report our experience: 146 clinical cases over 35 months from January 2017 to December 2019. The patients were divided for 4 groups depending on which type of graft was used. Conclusions Use of autogenous deep temporal fascia, rectus abdominis fascia, and diced cartilage in fascia (DC-F) to camouflage dorsal irregularities, to highlight dorsal aesthetic lines, and to aesthetically augment either the entire nasal dorsum or its individual parts. Optimization of cutting, stitching, filling the graft, careful fixation of these grafts on the nasal dorsum, significantly increases the predictability of these techniques and minimizes problems.

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Correlating the Volume of Diced Cartilage Grafts and the Gain in Nasal Dorsal Height Following Nasal Dorsum Augmentation

The Egyptian Journal of Plastic and Reconstructive Surgery ◽

10.21608/ejprs.2020.68168 ◽

2020 ◽

Vol 43 (3) ◽

pp. 396-399

Author(s):

Nada Mahmoud ◽

Karim Massoud

Keyword(s):

Nasal Dorsum ◽

Cartilage Grafts ◽

Diced Cartilage

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Outcome of Free Diced Cartilage Grafts in Rhinoplasty: A Systematic Review

Facial Plastic Surgery ◽

10.1055/s-0040-1714664 ◽

2020 ◽

Author(s):

Taynara Oliveira Ledo ◽

Helena Hotz Arroyo Ramos ◽

Cibele Madsen Buba ◽

Guilherme Webster ◽

Jesse Teixeira de Lima Jr ◽

...

Keyword(s):

Systematic Review ◽

Infection Rate ◽

Systematic Search ◽

Nasal Dorsum ◽

Cartilage Graft ◽

Exclusion Criteria ◽

Cartilage Grafts ◽

Partial Resorption ◽

Diced Cartilage ◽

Graft Resorption

AbstractDiced cartilage grafts are used to increase and refine the nasal contour, providing easy molding and versatility when compared with block grafts. However, all grafts present the possibility of visibility, distortion, and absorption. The aim of this study is to evaluate, through a systematic review, the outcome of the use of the free diced graft cartilage in rhinoplasty. A systematic search of the literature was performed in the databases (PubMed, Lilacs, Scielo, Cochrane) with the terms “diced cartilage” and “rhinoplasty.” Studies were selected according to the inclusion and exclusion criteria and data extracted and grouped for analysis. Six eligible studies were included. In total, 4,044 patients underwent rhinoplasty with free diced cartilage graft, with 61 (1.51%) of them requiring reoperation. The main reasons were overcorrection and irregularities of the nasal dorsum. The infection rate was reported in three studies, with 2 (0.06%) of 3,252 patients presenting infection at the graft site. Two cases of displacement were treated with external molding, without reoperation. The graft resorption was reported in four articles, which described 22 (0.67%) cases of partial resorption in 3,288 patients. Therefore, the available evidence suggests that resorption of the graft and unfavorable outcomes are rare.

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