Correction of Overresection With Non-Rib Cartilage Wrapped in Fascia Publisher



Naraghi M¹ Show Affiliations
Source: Rhinoplasty: A Case-Based Approach Published:2022

Abstract

In secondary rhinoplasty cases with over resection, cartilages are the most required materials for grafting in multiple structural and surface defects. The selection of the ideal graft has been an issue of concern for its donor site morbidity and other possible problems such as graft visibility and irregularities, infection, and inflammatory reactions. Advances in facial plastic surgery persuaded us to use special techniques to decrease donor site morbidity for using autografts. Combining open and endoscopic approaches can provide adequate support for structural and camouflage purposes exclusively from the non-rib sources with the most negligible morbidity and successful results. Diced cartilages from the remnants of the ear and septum can be wrapped in fascia temporalis, avoiding any graft harvest from the rib and other distant areas. This chapter will focus on the minimally invasive technique of non-rib cartilage wrapped in fascia temporalis. Details of the procedure are described through illustrative pictures of the operating view, emphasizing the pearls and pitfalls in every stage. Lack of visibility over time, decreased the risk of torsion and warping of graft, better attachment to the recipient bed, camouflaging underlying asymmetries and postoperative flexibility and shaping are some advantages of the author’s preferred technique. © 2023 Elsevier Inc. All rights reserved.