Augmentation Rhinoplasty with Dermal Graft and Review of the Literature

Abstract

Nasal augmentation required following a trauma or a rhinoplasty operation poses a challenging problem to many plastic surgeons. Currently, allografts and autologous tissues are used for nasal augmentation; however, an ideal technique has not yet been described. Although preferred for augmentation of different parts of the body, pure dermal graft use has not been described for nasal augmentation. The authors performed nasal augmentation using a dermal graft in 90 patients in their hospital between 1994 and 2000, and they followed up the patients for 6 months to 8 years. In this article, the early and late results of dermal grafts for nasal augmentation are presented, and their advantages and disadvantages are discussed with a review of the literature. It was concluded that the easily obtained dermal graft could be an appropriate alternative in nasal augmentation, though it has not been used widely for this purpose.

Comparison of Autogenous Cartilage, Acellular Dermis, and Solvent-Dehydrated Pericardium for the Prevention and Correction of Dorsal Nasal Irregularities: An Experimental Study

“…They are easily shaped, the operative procedure is quite fast, and smooth contours are achieved. High resorption rates, donor site scars, and rare cystic formations are their disadvantages [1,2,15]. If the thickness of the dermal graft is insufficient, an unsuccessful outcome may occur [1,2].…”

“…The resorption and biocompatibility features of AC, SDP, and ADM have been shown in previous studies [1,2,8,15,[22][23][24][25][26]. However, there are still questions about the correlation between results and clinical experience, which may be caused by the sophisticated structure of the osteocartilaginous junction formation after hump resection.…”

“…In patients with thin skin, graft materials are occasionally used in primary rhinoplasty procedures for the prevention of visible dorsal nasal irregularities [1][2][3][4][5][6]. Cartilage, dermis, temporal fascia, superficial musculoaponeurotic system (SMAS), Vicryl mesh, gelatin film, polytetrafluoroethylene, Surgicel-wrapped diced and crushed cartilage, tensor fascia lata, and acellular dermis are among the most commonly used materials to correct contour deformities and provide a subcutaneous pad [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Each material has certain advantages and disadvantages but a controversy about the ''best material'' still exists.…”

Comparison of AlloDerm, Fat, Fascia, Cartilage, and Dermal Grafts in Rabbits

“…This material survives as living tissue, does not stimulate an immune response, and seldom undergoes resorption. 4,5 However, these characteristics are not shared by the other dorsal onlay graft materials, which include fat, 6,7 fascia, 8 dermis, 2,9 and AlloDerm. 3,10,11 The literature contains contradictory data about the resorption rates and the predictability of these graft choices.…”

“…7,13,14 Some authors advocate using dermal grafts owing to their limited postoperative absorption rates and stability, 2,15 whereas others report resorption rates varying from 11% to total volume loss. 9,16 Similarly, although AlloDerm has been suggested to be an ideal graft material for secondary rhinoplasty surgery to create a smooth dorsum with no resorption, 3 partial graft resorption has been reported by some authors. 11 As a result of this conflicting information and the differing resorption rates of these graft materials, most surgeons are hesitant to use these materials for contour restoration in rhinoplasty.…”