Simple method of saddle nose correction: A double-layer dermofat graft: case report

Abstract

Introduction: Saddle nose deformities are typically reconstructed with cartilage grafts; however, conchal cartilage grafts are and associated with a risk of damage to the posterior auricular ligament and insufficient amounts, and costal cartilage grafts require invasive surgery under general anesthesia. We proposed a double-layer dermofat graft as an alternative to these methods.Patient concerns: Two patients with type IV saddle nose deformity underwent reconstruction with nasal augmentation with a double-layer dermofat graft harvested from the gluteal sulcus.Diagnosis: After operation, photogrammetric analysis demonstrated an improvement in the dorsal depression area, which corresponded to the angle between the sellion, most depressed point, and pronasale. Rhinoplasty Outcome Evaluation questionnaire was assessed. Interventions:The graft was divided into 2 sections; the first section was implanted transversely into the depressed nasal framework, and the second section was inserted vertically from the nasion to the supratip break for augmentation.Outcomes: Both patients reported high satisfaction with the Rhinoplasty Outcome Evaluation questionnaire. The mean preoperative angle between the sellion, most depressed point, and pronasale was 157.8°, and the mean postoperative angle at 6 months was 176.9°. Conclusion:The simple method double-layer dermofat graft technique demonstrated excellent outcomes in saddle nose deformity correction, did not require cartilage, and was easily performed under local anesthesia.

The current techniques in dorsal augmentation rhinoplasty: a comprehensive review

“…Fat cannot be injected quickly into a surgical field in all these cases. I camouflage nasal irregularities using autologous fat and restore atrophic nasal skin [ 6 , 89 , 90 ]. The skin must heal over the nasal supports before or after the nasal supports are rebuilt by injecting autologous fat.…”

“…It is more likely that larger fat parcels will result in dislodgment, nodulation, and irregularities of the skin following implantation. Studies that use fat grafting for rhinoplasty usually use lipo injections to refine or reconstruct the nose [ 6 , 89 , 90 ].…”

“…The gluteal sulcus dermofat graft was used to reconstruct a double-layer saddle nose in two patients with type IV deformities. A practical method for correcting saddle nose deformities using a double-layer dermofat graft, performed under local anesthesia and without cartilage, demonstrated excellent results [ 90 ].…”

Innovative Non-Surgical Plastic Technique for Saddle Nose Correction: A Study on 97 Patients

“…Different body sites to collect cartilage in the human body are employed (septal, conchal, costal, calvarial, and iliac bones cartilage), although many limitations exist, such as the insufficient yield of material and the risk of injury in the harvest site. For these reasons, the refinement of a non-surgical correction method is acquiring huge relevance to achieve the best result in profile restoration as an alternative to standard surgical procedures [3].…”

“…Non-surgical correction is one of the best choices in mild cases of saddle nose, and it represents a solution for the aesthetical amelioration of facial deformity; nevertheless, in most critical cases, surgical intervention is still required. The non-surgical procedure consists of the injection of dermal fillers in the nasal skin-soft tissue in order to restore the nose structure, increasing the height of the nasal bridge [3]. Non-surgical corrections are characterized by many benefits, such as short recovery time, few post-surgical complications, and cost-effectiveness.…”