Abstracts

DORSAL NASAL AUGMENTATION USING A “SANDWICH” GRAFT CONSISTED OF MORSELIZED CONCHAL CARTILAGE AND RETROAURICOLAR FASCIA.

Dr. Nicolae Antohi

Hospital for Plastic Surgery and Burns, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

Introduction.
The main disadvantages of the conchal cartilage graft are its curvature and irregularities. Even crushed or attenuated conchal cartilage can cause irregularities over time. The purpose of this study was to modify the conchal graft and to combine it with the retroauricular fascia creating a flat "sandwich" graft for dorsal nasal augmentation.

Material and method.
Between December 2008 and December 2009 fifteen patients underwent dorsal augmentation by using "sandwich" graft consisted of conchal cartilage and retroauricular fascia. Among them two primary and twelve secondary rhinoplasties. In all cases which were performed through open approach, the "sandwich" graft was used as a contour graft for aesthetic purpose after ensuring nasal framework stabilization.
Both grafts are harvested through the same incision in the retroauricular groove. The conchal graft is slightly morselized. To get a straight, flat and pliable graft the conchal cartilage is cut in two or three pieces, suturing them to each other, and fixed to the retroauricular fascia with separate 6/0 PDS stitches. The "sandwich" graft is placed on the nasal dorsum in sub-SMAS pocket with the retroauricular fascia up.

Results.
The follow-up revealed no case of infection, resorption or displacement of the graft. Satisfactory aesthetic result was achieved in all patients. There were no complications in the donor area. The thickness of the combined graft could be up to 4 mm.

Conclusions.
The method is appropriate for slight and mild dorsal augmentation and for smoothing the dorsal line. The fragments of the conchal graft could be also fixed to the fascia asymmetrically depending of the dorsum shape.

Key words: dorsal nasal augmentation, retroauricular fascia, “sandwich” graft.

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