Complete or a Partial Sheet of Deep Temporal Fascial Graft as a Radix Graft for Radix Augmentation

Abstract

Autogenous fascia, including the temporalis fascia, has a particular role in rhinoplasty as radix and dorsal onlay grafts. The main purpose of this study is to achieve desired appearance of facial harmony using either a complete or partial sheet of deep temporal fascia as a radix graft in the patients with required permanent radix augmentation. This is a prospective study of 15 patients who referred to Gandi Day Clinic, Tehran, Iran, between 2005 and 2006 and underwent rhinoplasty including nasal radix augmentation using deep temporalis fascia through external rhinoplasty approach. The patients with hump noses had low radix and required radix augmentation. Full sheet facial graft was used in 13 patients. Partial sheet facial graft was used in two patients. As a donor site problem, minor hematoma was observed in one patient. Temporary hair loss in incision line was another problem which were seen in five. As for the recipient site, no infection, persistent erythema of nasal skin extrusion, visibility, displacement of graft materials or irregularity of graft contour were observed postoperatively. Resorption rate was approximately 30% for grafted fascia. Using fascia grafts in radix point, the revision rate was minimal. In order to augment the radix, if 4 mm augmentation is needed, it should be considered that full sheet fascia graft alone would be insufficient. If more than 4 mm of augmentation is needed, 30% overcorrection would manage well the permanent radix augmentation without any problem.