Hello, I've had two bad rhinoplasties, with the last one leaving my nose completely deformed. :( I've visited three top doctors in my country, and each one told me s/he would use different grafts, such as rib, or fascia. I'm not really a fan of the idea of rib grafts, considering the warping, stiffness etc.So i'm wondering what are the downsides of fascia grafts. Are they good for reconstructing a major part of the nose? Do they last through time? Thank you in advance for your time! :)
Fascia Grafts for 3rd Revision Rhinoplasty: is This Safe? Will It Last? What Are the Downsides?
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Doctor Answers 3
Grafts for 3rd Rhinoplasty
The source of grafts for another revision will depend on what you need. I've used fascia grafts, some filled with diced cartilage for over 30 years and have found that they will last. Make sure you select a surgeon who specializes in revision rhinoplasty.
Fascia grafts and diced cartilage fascia graft work very well
I use fascia (temporalis or mastoid periosteum) grafts quite frequently in my revision cases. They are thin and pliable yet also quite strong pieces of tissue used to contour the nose. Fascia grafts are obtained from either a scalp incision or one placed behind the ear. Occasionally patients will complain about pain with chewing if a temporalis (scalp) graft is used. This pain is transient and usually goes away in 2-3 days. These grafts are excellent in camouflaging imperfections and providing a blanket so as as to disguise cartilage grafts in patients with extremely thin skin. Diced cartilage wrapped in a fascia graft is ocassionally called a "turkish delight" after the candy of the same name. These graft are usally more rigid and provide excellent augmentation to the bridge of the nose is cases of overresection or saddling. I hope this information helps.
I am so sorry to hear your delema. If you have had two previous Rhinoplasty and things are still not right you are correct grafting most likely will be required. Sources of grafting include septal, auricular, fascia, fat dermal, rib, radiated tissue (cartalage), artifical amterial, etc. Yes, fascial grafts are one of the most common. Many times cruched or cut up cartalage is wraped in fascia and utilized as a graft. It works quite well.
Since this is your third Rhinoplasty make sure you do your homework and choose a very competant, experienced and knowledagable surgeon. Do not let advertising be your guide. Best,
Gary R Culbertson, MD, FACS
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