Dorsal refinement with Deep Temporal Fascia - Part 1: Preparation and Wrapping

September 3, 2018

Placement of diced cartilage enclosed within an autologous fascia sleeve (DC-F) for nasal dorsum reconstruction is common in open rhinoplasty. Among that, Deep Temporal Fascia (DTF) is one of the best solutions for dorsal refinement to fix the thinning and damaged skin in secondary rhinoplasty. 

 

This week, IFAAS Faculty Dr Jae Yong Jeong, a plastic surgeon with 15 years of Asian Rhinoplasty experience from South Korea shares his exclusive technique on Dorsal refinement with Deep Temporal Fascia - Part 1: Preparation and Wrapping in the following video.

 

This patient has went through 3 operations using silicon implant and because of that, her dorsal skin is becoming thinner. Dr Jeong harvested deep temporal fascia and wrap it to strengthen the skin in this case. 

 

 

3 Top Tips from Dr Jae Yong Jeong

  • By using Deep Temporal Fascia, it is nearly impossible to elevate more than 3 mm of the nose bridge. Therefore it is used to refine the dorsal not to create height. 

  • If the patient's nasal height is low, deep temporal fascia can be used as a combined graft with cartilage to create natural aesthetic lines and improve undesired dorsum and tip deformity.

  • Handling of Temporal Fascia is slippery and hence, it may be an uphill task while handling the tissue. 

 

Process of Dorsal refinement with Deep Temporal Fascia

 

Dorsal nasal grafts are inserted to support the soft-tissue envelope of the nose at its thinnest region over the rhinion to more likely produce visible contour defects if they become warped or misplaced. A significant percentage of cartilage grafts (taken from the septal, conchal, or rib cartilage) is also placed in the radix or middle part of the dorsum. With time, it will become unattractively noticeable. To address this problem, a surgical technique of diced cartilage micrografts is wrapped in an enclosing sleeve. Noticeable edges of the graft can thus be avoided help surmount the problem of long-term cartilage warping following the placement of a single fragment.

 

 

 

Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4656167/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4738128/

 

 

Enjoyed this article? Stay tuned for our next week's newsletter, Dr Jeong will be sharing his personal technique on The Placement of the Deep Temporal Fascia for Dorsal Refinement. 

Learn more about the cutting-edge techniques in Asian Rhinoplasty and practise the techniques through experts-led hands-on training: 

 

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