Long-Term Resorption Rate of Autogenous Onlay Graft in East Asian Rhinoplasty: A Retrospective Study

Overview

The patient's own tissue is the preferred graft material in rhinoplasty, but how much is absorbed over time is disputed and long term studies are rare. This study assessed resorption of different graft types on the upper third of the nose, reviewing patients who had bridge augmentation with their own tissue between 2009 and 2018.

Sections of note

• Retrospective record review; therapeutic level of evidence III.
• Grafts were grouped into three: rolled superficial mastoid fascia, diced cartilage wrapped with superficial mastoid fascia, and rolled sacral dermis.
• Before and after photographs were used to assess resorption rates and projection.
• The rolled sacral dermis group showed a steep initial rise in projection followed by a sharp decrease over long term follow up.
• Significant trend differences were found at the rhinion and at the half nasion to rhinion point, both P less than 0.001, but not at the nasion.
• The rolled sacral dermis group showed the most projection, followed by diced cartilage wrapped in fascia.
• The highest resorption rate was in the rolled superficial mastoid fascia group, P less than 0.001.
• Between the other two, rolled sacral dermis resorbed more than diced cartilage in fascia.

What it means for a patient

• At least half the added height was lost in almost every group, whatever material was used.
• Fascia alone resorbed most; diced cartilage wrapped in fascia held up best of the three.
• Dermis produced the largest immediate rise but the sharpest later loss.
• Measurements came from photographs, and the abstract states neither patient numbers nor follow up length.

Why this paper matters

Bridge augmentation is judged years after surgery, and resorption determines whether the result holds. This study measures it across three common materials over an extended period. The absence of stated patient numbers and follow up length limits how far the figures can be applied.

Terms

• Onlay graft: material laid on the bridge to add height.
• Resorption: gradual absorption and loss of graft material by the body.
• Superficial mastoid fascia: a fascia layer taken from behind the ear.
• Sacral dermis: deep skin layer taken from the lower back.
• Rhinion: where the nasal bones meet the cartilage on the bridge.
• Nasion: the point at the root of the nose between the eyes.