Out of the various cartilages used in rhinoplasty temporal fascia harvesting is one of the most widely used. Usually in the Asian population nose and tip augmentation procedures are followed simultaneously. Majority of the nose augmentation involve implants. It is observed that is the process of nose augmentation, grafts using deep temporal fascia is used for primary rhinoplasty. This only helps the autologous tissues to improve the hump or the curve of the nose. In the case of secondary rhinoplasty temporal fascia is used to improve the implant demarcation and transparency. Temporal fascia is also widely used in cases of reconstruction surgeries of the face and exposed tendon injuries. Temporal fascia harvesting is also preferred as it provides sufficient volume for creating a smoother and better nose contour which is the major aim in cases of nose and tip augmentations. This leads the patients with usually less scars and making it applicable as a material for various grafts used in rhinoplasty.
Temporal Fascia Harvesting for the use of cartilage in Rhinoplasty is especially useful for Asian ethnicity people as they have a low and flat dorsum and the nasal tip is not projected. Also the weak cartilages and thick nasal skin make them ideal candidates for this type of harvesting.
The temporal fascia harvesting is used in the primary surgery cases with no implants in various graft methods for radix and supratip depression augmentation for cases such as hump nose or tip deformities completely depending on the patient’s requirement and medical condition. In secondary cases, the temporal fascia is used to reinforce thinned skin and soft tissues after removing thickened capsules for improvement of implant demarcation from the contracture.
Rhinoplasty is performed by inducing the local anesthesia. Temporal fascia harvesting as a part of cartilage in Rhinoplasty surgery is done by making an incision of 3 cm to 4 cm along the temporal regions, along the patient’s posterior border of the sideburns. A dissection is done on the subcutaneous tissue and the superficial temporal fascia, paying requisite attention to the hair follicles and temporal arteries and veins. According to the requirement of the recipient, superficial temporal fascia is included when volume or smoothly movable planes are required. The temporal fascia to be harvested is identified according to the amount required and then incised, avoiding the vessels in the temporal muscles. This amount is determined by surgeon on the basis of the internal and external nasal examination done in advance before recommending the use of cartilage in rhinoplasty.
However hump nose correction without an implant, curve irregularity and other depressed areas is generally improved by combined grafts with cartilage as means of wrapping or solely by just fascia as a free graft method. Usually this technique is used in the secondary rhinoplasty because cartilages in rhinoplasty give better results. .
Temporal fascia does promise long term benefits, and the surgeons take full measures that the desired results are delivered to the patients without causing them any discomfort or pain. During fascia harvesting the incision is made above the ear and completely contained within the hairline therefore the chances of scars being visible is greatly maintained. By obtaining the proper amount of tissues, the incision is closed with the help of absorbable sutures or staples. Once healed, the scars are hardly visible and even if they are it’s just a minimal visibility. The harvested cartilage is the part of the patient’s own tissue therefore the risks of infections and rejections are highly minimized. Also since they are completely natural, they even appear natural. Also the added advantage is that it the harvesting and installation of the cartilages in rhinoplasty can be done in the same procedure. Most patients are satisfied and exhibit quick recovery time within a week of the procedure.