Nasal reconstruction with double-layer tensor fascia lata-wrapped diced rib cartilage in a patient with severe dorsal collapse.

For patients with large dorsal defects due to posttraumatic deformities, rib cartilage or calvarial bone is used for reconstruction. Problems such as graft contour, distortion, limited amounts, and donor morbidity continue to exist for cartilage and bone grafts. To overcome the limitations of such grafts, many authors have used diced cartilage wrapped with fascia. However, diced cartilage wrapped with fascia is not suitable for structural support in cases of dorsal nasal collapse. We describe a technique using a dorsal structural graft for a 28-year-old man who had severe dorsal nasal collapse after a traffic collision. For enhancement of strength, we harvested a thick segment of the tensor fascia lata and applied 2 layers. A large amount of rib cartilage was inserted between the thick fascia layers. The tensor fascia lata wrapped with diced cartilage graft for dorsal augmentation is fraught with structural graft, similar to bone or cartilage grafts. This semirigid technique may be another option for dorsal structural support of severe nose deformities.