title: Immediate reconstruction after removal of nasal prosthesis using diced cartilage wrapped with temporal fascia.
abstract: Various materials are used for nasal augmentations. Silicone is the most prevalent because it is durable and facilitates sculpturing. However, the unfortunate patient who presents with complication of the nasal implants and wants to remove them is vexed with a significant resultant cosmetic defect if the implant is removed. However, the patients who have some troubles after augmentation by the implants tend to hate the use of the prosthesis again. Ideally, immediate reconstruction would be offered to the patient, sparing him/her the deformity left by removal of the implant. We treated 16 patients who had undergone immediate nasal reconstruction after removal of foreign body. We reconstructed nasal deformity by diced cartilage wrapped with temporal fascia. The cartilage harvested from the ear concha was finally diced into 1- to 2-mm cubes. A bag was made from deep or superficial temporal fascia, and diced cartilage cubes were placed in the bag, which was grafted onto the nasal dorsum. This procedure had several advantages including getting natural contouring and enough volume and absence of foreign body reaction. It was also soft to the touch compared with prosthesis. The fascia could support the thin dorsum skin. The nasal augmentation effect of this procedure was comparable with that of prosthesis methods. It had lower risks for infection and exposure and provided more psychologic comfort. The nasal deformities were successfully reconstructed using diced cartilage wrapped with temporal fascia. We believe that this is the good method for the immediate nasal reconstruction after the removal of foreign body.
authors.affiliation: From the *Department of Plastic and Aesthetic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan; and †Jiyugaoka Clinic, Meguroku, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Takeda
authors.forename: Minekatsu
authors.initials: M
authors.lastname: Akimoto
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Kazumi
authors.initials: K
authors.lastname: Himi
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Shimakura
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Furuyama
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Nakakita
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D005205:Fascia / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D019736:Prostheses and Implants / Q000009:adverse effects; D019651:Plastic Surgery Procedures / Q000379:methods*; D012225:Rhinoplasty / Q000379:methods*; D012828:Silicones / Q000009:adverse effects
chemical_list: D012828:Silicones