Mastoid Fascia Tissue Graft as a Tip Camouflage Technique in Rhinoplasty: A Reliable Alternative to Soft Cartilage Grafts

BACKGROUND: Traditional rhinoplasty tip grafts often lead to visibility issues, prompting patients to seek revision surgery. The mastoid fascia tissue graft (MFTG) provides a natural-appearing alternative with an acceptable risk of complication. The MFTG remains less visible through the skin and helps camouflage and conceal tip irregularities. This study of 193 patients examines the MFTG's effectiveness in nasal tip refinement, evaluating revision and infection rates.

METHODS: A retrospective analysis of MFTG use for nasal tip appearance during open rhinoplasty in the senior author's (R.G.R.) practice was conducted, covering the period from January of 2019 to June of 2022. Inclusion criteria encompassed open rhinoplasty cases using mastoid tissue for tip appearance with at least 12 months of follow-up. Among 2003 cases, 193 met these criteria and were evaluated for subsequent revision and infection rates.

RESULTS: The average patient age was 34.2 years (175 female patients and 18 male patients). Primary rhinoplasty was performed in 113 patients, with 80 receiving revision operations. The average follow-up was 14.8 months. Six patients (3.1%) overall needed extended antibiotics, including 1 primary rhinoplasty patient (0.9%) and 5 secondary rhinoplasty patients (6.3%). Overall, revision rhinoplasty was required in 6 patients (3.1%) (1 primary patient [0.9%] and 5 secondary rhinoplasty patients [6.3%]).

CONCLUSIONS: MFTG use for an aesthetically pleasing nasal tip appearance is a safe, convenient, and effective technique for camouflaging and concealing nasal tip contour irregularities in both primary and revision rhinoplasty. Use of the MTFG is associated with minimal morbidity.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.