Can the bridge be enhanced without harvesting the scalp fascia for rhinoplasty?

I am planning on rhinoplasty with ear graft, but was told the ear cartilage needs to be diced and wrapped with scalp fascia , will it cause any side effect to the head ? can the ear cartilage be used without being wrapped by fascia or any other material could simply replace it?

Doctor Answers 10

Dorsal nasal augmentation

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Wrapping diced ear cartilage in fascia is not at all uncommon.  The donor site for the fascia is really no big deal at all.  Of course without photos I can't comment on whether or not you are an appropriate candidate for this procedure.  Incidentally, I have never found it necessary to use this technique, but it is a commonly used approach.

Scalp Fascia Is Important for Diced Cartilage

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Hello,

You'll need the fascia to preserve the diced cartilage. Other 'wraps' have been used, specifically acellular dermal matrix products, however the longevity of the grafts were not as good as with fascia. Harvesting of fascia has very low morbidity and does not contribute to much discomfort. Best of luck!

Diced Cartilage Graft

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This is a well described procedure. Using diced cartilage is great for dorsal nasal enhancement and along the bridge that you describe here. Studies showed that when you wrap the diced cartilage in temporal fascia as you describe that the cartilage was less likely to reabsorb over time. Dr Rollin K Daniel in Orange County has written on this topic greatly inner literature and has well described this. Cartilage alone will likely re-absorb over time. Your surgeon is correct that the scalp incision will be hidden and using that tissue will cause not functional or cosmetic problem at all. Sounds like you are getting good advice from a good surgeon, but I have not idea who they are obviously. 

Bridge Augmentation

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There are many different techniques for augmenting the bridge from cartilage to implants. Why you need ear cartilage used as opposed to septal cartilage which is straighter you did not state in your inquiry. But the use of ear cartilage for bridge augmentation means it needs to be diced and wrapped in something. Fascia is one option but there are other options as well that do not invoke harvesting fascia.

Diced ear cartilage with fascia, ear cartilage without fascia, septal cartilage, etc.

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 Diced ear cartilage with fascia, ear cartilage  without fascia, septal cartilage, etc. for bridge augmentation?  I, like many other revision rhinoplasty specialists have used all of these techniques. Do not choose the technique but rather choose the surgeon whose results with revision rhinoplasty and bridge augmentation look the best to you. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Wrapping cartilage with fascia

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Ear cartilage is often diced and used as filler material to build up the bridge of the nose. Fascia is not always used but some surgeon's do prefer to wrap the cartilage in fascia to help shape and maintain the position of the cartilage. If done correctly, the fascia can be harvested safely and without any long term side effects beyond a small incision site. It best to discuss your concerns with your plastic surgeon to see if he or she can provide alternatives which are in line with your own goals. Hope this helps!


Johnson C. Lee, MD Plastic Surgery

Cartilage Grafts to Bridge Withot Fascia

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Cartilage grafts can be used to augment the bridge without wrapping them in fascia. However diced cartilage wrapped in fascia do allow us to shape the graft without irregular edges of solid pieces of cartilage and the fascia does enhance circulation to the graft which improves graft survival. I have used both approaches over many years but now prefer the fascia wrap in patients who need significant augmentation.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Nasal dorsal enhancement

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Thank you for the question and you have several options other then ear grafts and fascia to reliably enhance the dorsum of the nose.  So go on some more consultations with experts in the area and become informed.


Dr. Corbin

Can the bridge be enhanced without harvesting the scalp fascia for rhinoplasty?

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In our practice, we always use septal cartilage first is the primary source of grafting material to build up the bridge of the nose. If there is a cartilage depleted nose, then consider ear cartilage. The fascia just keeps the diced cartilage together as a unit.

Building up bridge of nose

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I would recommend you get a second opinion. I do not use scalp fascia, and perform ear cartilage grafts. Not all surgeons will perform the grafts with fascia wrapping. There are many ways to build up the dorsum of the nose. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.