From the humble and exceedingly primitive origins of dorsal augmentation with materials such as ivory and jade in the mid-20th century, contemporary techniques have seen a focus on minimizing complications associated with alloplastic implants and an ongoing shift towards maximizing results with autologous grafts. Alloplastic implants have enjoyed rapid and widespread acceptance by surgeons performing Asian rhinoplasty given the inherently facile nature of a pre-fabricated graft, with its associated time and cost savings, relative ease and rapidity of placement, lack of any donor site morbidity or complications. Despite the excellent results achieved by many pioneering surgeons, complications including infection, graft migration, thinning of overlying nasal skin envelope, and even the disastrous sequela of implant extrusion, led many to seek out modifications to improve the safety of using alloplastic materials while preserving the level aesthetic results.
The landscape of dorsal augmentation today maintains variance, from the basic single synthetic implant techniques, to the more involved alloplastic dorsal implant combined with autologous graft approaches, to the more sophisticated autologous graft techniques utilizing onlays of cartilage, or diced cartilage fascia (DCF).
Before and After Asian rhinoplasty to create greater definition of the dorsum (bridge) and tip of the nose using rib cartilage and diced cartilage fascia (DCF).
