Fascia lata graft for nasal dorsal contouring in rhinoplasty

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Summary

Nasal dorsal irregularities are troublesome for both patient and surgeon, especially in patients with thin nasal dorsal skin. Many types of grafts have been used for nasal contouring; however, in this article, we report the use of fascia lata (FL) graft for dorsal contouring and camouflage in 63 patients who underwent rhinoplasty between May 2004 and December 2005. There were 26 male and 37 female patients, with ages ranging from 18 to 43 years (mean age: 28.7). Of the 63 patients, 49 underwent primary rhinoplasty, while 14 were secondary cases. An informed consent was obtained from all patients for the use of FL graft. The graft was harvested from the right lateral thigh. A simple method was used to place the graft over the nasal dorsum. Postoperative follow-up period was between 14 and 26 months (mean: 20). Clinical evaluation was made by inspection, palpation and photographic documentation. In addition, a questionnaire related to patient satisfaction and donor-site morbidity was sent to patients 1 year after surgery. All patients had satisfactory aesthetic results, and no apparent irregularities were observed over the nasal dorsum. The questionnaire results showed that all patients, but one, were satisfied with surgery, and were not concerned about donor-site scar; however, one patient had a donor-site morbidity. This study conclusively shows that TLF graft is a reliable, simple method for camouflaging any postoperative dorsal irregularities, particularly in patients with thin nasal skin.

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Patients and methods

In this study, we consider 63 patients who underwent rhinoplasty between May 2004 and December 2005, of which 26 were male and 37 were female patients, and their ages ranged from 18 to 43 years (mean age: 28.7). An informed consent was obtained from all patients in case of possible use of FL graft during surgery. The FL graft (average size: 2 × 3 cm) was uniformly harvested from the right lateral thigh by performing a 1.5 cm incision, located 15–20 cm proximal to the insertion of tensor FL muscle at

Results

Of the 63 patients, 49 underwent primary rhinoplasty, while 14 were secondary cases. Out of the 49 primary patients, 27 presented with a nasal deformity due to a trauma encountered previously.

Patient selection was based on the fact that all had a characteristic thin parchment nasal skin. FL graft was used to camouflage the possible dorsal irregularities in late postoperative period. All patients had satisfactory aesthetic results, and no apparent irregularities were observed over the nasal

Discussion

The use of FL in eye lid ptosis surgery is well known in the literature; moreover, it is widely applied in ligament reconstruction in orthopaedics surgery.7 Autografts and allografts have been widely used to improve the contour of the nose, including the dorsum,9, 10, 11, 12, 13, 14, 15, 16, 17 lateral walls15, 18 and nasal tip.19, 20, 21, 22 Cartilage grafting has been demonstrated to be effective in improving both the functional and the cosmetic aspects of the nasal framework. In addition,

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