Multifragmented Cartilage Wrapped with Fascia in Augmentation Rhinoplasty

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Abstract
Dorsal nasal contour can be improved by using fragmented or crushed cartilage grafts wrapped with fascia in patients with dorsal nasal deformities. The authors obtain cartilage from the ear concha that is fragmented or crushed. Fascia is harvested from the temporal region. Multifragmented cartilage is wrapped with deep temporal fascia, making a roll. After creating a cavity in the nasal dorsum, the bone is rasped and the combined roll graft is introduced, and appropriate modeling of the graft is mandatory. The authors have operated on 115 patients with this procedure, 68 primary operations and 47 secondary operations, over a 13-year period. In the great majority of cases, results were excellent. To avoid deviation of the roll graft, it is important to prepare a straight cavity. Especially in secondary cases, seroma is manifested by swelling and reddish skin color, which is removed with a 2-mm incision made with a no. 15 knife and constant pressure over the nose for some minutes. The authors have observed only five primary cases with seroma and 13 secondary cases. This procedure in the authors' hands has given magnificent aesthetic long-lasting results and a "natural appearing" outcome.

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