Use of Tutoplast-Processed Fascia Lata as an Onlay Graft Material for Tip Surgery in Rhinoplasty

Objectives. Tutoplast-processed fascia lata (TPFL) is a commercially available homograft that has been successfully used as human graft tissue for dorsal augmentation in rhinoplasty. The present study evaluated the use of TPFL as an onlay tip graft material in rhinoplasty. Study Design. Case series with chart review. Setting. Academic tertiary care medical center. Subjects and Methods. The study involved a retrospective analysis of rhinoplasty cases using TPFL as a tip onlay graft. The study included 82 patients (46 men and 36 women) who underwent tip surgery using TPFL from February 2006 to June 2008. By comparing facial photographs before and after the operation, 2 independent rhinoplastic surgeons assessed outcomes of 8 months postoperative time as being excellent, fair, or poor. Using the pre- and postoperative profile view, anthropometric measurements were also made. Results. The 82 subjects included 71 primary and 11 revision patients. TPFL was used as a tip onlay graft in final tip modification. Postoperative assessment found that only 6 (7%) patients had excellent results, 51 (62%) had fair results, and 25 (31%) had poor results. Pre- and postoperative anthropometric measurements showed the technique resulted in an overall increased nasal tip projection postoperatively (0.56 +/- 0.09 vs 0.60 +/- 0.08; P < .05). However, the overall nasolabial angle was not changed after surgery (91.35 +/- 10.36 degrees vs 93.05 +/- 8.3 degrees; P = .08). No patient experienced infection, visible graft contour, or migration. Conclusion. TPFL was not that satisfactory in terms of aesthetic outcome when used as a tip onlay graft material in rhinoplasty patients.