Dorsal Nasal Augmentation With “Open Sandwich” Graft Consisting of Conchal Cartilage and Retroauricular Fascia

Abstract

The autologous chondrofascial graft is appropriate for slight to mild dorsal nasal augmentation. The method, as with most rhinoplasty techniques, requires careful and judicious preoperative examination, planning, and execution. The postoperative scar is inconspicuous and the donor site morbidity is minimal.

Dorsal Nasal Augmentation: Is the Composite Graft Consisting of Conchal Cartilage and Retroauricular Fascia an Effective Option?

“…Saving the posterior auricular muscle prevents alteration of the position of the ear. 11 Considering these critical points, a rectangular piece of retroauricular fascia (maximum, 5.0 Â 2.5 cm; thickness, $2 mm) could be harvested by a sharp incision of the soft tissue overlying the mastoid bone (Figs 2-4).…”

“…Various donor sites (including the nasal septum, conchal cartilage, and rib) are available for cartilage harvesting in rhinoplasty. [8][9][10][11][12][13][14][15] For most surgeons, the septal cartilage is the donor site of choice; however, if the septal cartilage is inadequate (eg, in patients with septal perforation) or in revision cases (in which the septal cartilage has been used in previous surgery), then the surgeon must choose other options. In these conditions, the conchal cartilage is a favorable choice.…”

“…This donor site usually offers adequate and available graft materials for less severe dorsal deficiencies. 10,11 Different methods, such as diced cartilage, diced cartilage wrapped in fascia, or diced cartilage covered with fascia, are used for dorsal augmentation. 5,[9][10][11][16][17][18][19] Concerns about the visibility of the graft edges and irregularities made by graft particles require surgeons to use different materials as cover.…”

“…10,11 Different methods, such as diced cartilage, diced cartilage wrapped in fascia, or diced cartilage covered with fascia, are used for dorsal augmentation. 5,[9][10][11][16][17][18][19] Concerns about the visibility of the graft edges and irregularities made by graft particles require surgeons to use different materials as cover. Superficial temporalis fascia, 20 fascia lata, 21 AlloDerm (LifeCell Corp, Branchburg, NJ), 9,22 and homologous material (Tutoplast; Davol, Warwick, RRI) 23 have been reported in the literature.…”

“…In addition, there are techniques that make use of different kinds of materials in combination with this cartilage not only to cover the irregularities, but also to enhance the volume of augmentation. 9,11 In 2012, Antohi et al 11 presented a technique for dorsal augmentation using a composite graft consisting of conchal cartilage and retroauricular fascia. The authors have applied the same technique for dorsal augmentation in patients with moderate to severe dorsal deficiency since May 2011.…”