Nasal dorsal augmentation using diced cartilage with and without semi-circumferential fascia: technical note and...

Nasal dorsal augmentation is a fundamental step of rhinoplasty. It must provide height, projection, but also respect the aesthetic lines. Grafts made with diced-cartilage are moldable and have the capability to adequately adapt to the patient's anatomy. Many techniques have been described, with or without fascia wrapping.

We describe two variations of the dorsal augmentation technique, using glued diced cartilage with and without semi-circumferential fascia. The cartilage is chopped, placed in a hemi syringe and covered with glue-tissue. A layer of fascia or perichondrium may be used to smooth the graft. It is still malleable and can be finely adjusted to the nose. We illustrate the technique and present the postoperative results; we used questionnaires to measure patients' and surgeons' satisfaction.

We included thirty-three patients, who underwent rhinoplasty with dorsal augmentation between September 2013 and January 2020. Nineteen were reconstructed with fascia, while fourteen, without. We chose the fascia technique mainly for women. There appeared to be greater satisfaction within the group with fascia, but not significant. Patients tended to be more satisfied if it was a first surgery rather than a revision, and if the origin of the deformity was anatomical, rather than post-traumatic or postoperative; women seemed more satisfied than men. There was no correlation between surgeons' and patients' satisfaction.

The choice of surgical technique is made on a case-by-case basis, adapting to the patient's anatomy. We describe two techniques that are relatively simple, easily applicable and at the same time, provide regular and smooth grafts.