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Investigation of Two New Grafting Techniques for Dorsal Augmentation Rhinoplasty: An Experimental Study with New Zealand White Rabbits

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  • Basic Science/Experimental
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Abstract

Introduction

Cartilage is an important source in supporting the structure of the nose for dorsal augmentation rhinoplasty. However, it is known that its viability is not always on the ideal level. Various wrap** materials are used to increase the strength of cartilage. Donor site morbidity, which develops following the harvesting of both cartilage and fascia as one such cover material, has attracted interest in recent years.

Objective

In this study, we aimed to investigate the potential of dermis and tendon autografts as alternatives to fascia and cartilage.

Material and Method

The sample of the study included 16 New Zealand white rabbits. The right auricular cartilage of all rabbits was amputated, and it was transformed into diced cartilage autografts. The dermis autografts from the right gluteal areas of the rabbits were deepithelialized, and lumbosacral fascia autografts were harvested from the same incision. Additionally, the Achilles tendon of each rabbit was harvested and transformed into diced tendon autografts. Four different autografts were embedded under the skin of each rabbit from 4 different pouches opened in the back of the rabbit. These autografts included diced cartilage alone (Intervention 1), fascia-wrapped cartilage (Intervention 2), dermis-wrapped cartilage (Intervention 3) and fascia-wrapped tendon (Intervention 4) autografts.

Results

Intervention 1 had the most irregular appearance, the outcomes in Intervention 4 were volumetrically smaller and softer. Connective tissue formed between the diced pieces in all interventions, and it was observed that the dermis and fascia had a capsule-like appearance, and their viability was preserved. The differences between the initial and final measurements of the volumes of interventions 1, 2 and 3 were statistically significant (p < 0.05). There was no significant difference between the initial and final volumetric measurements of intervention 4 (p > 0.05). More peripheral proliferation was observed in the interventions of fascia-wrapped and dermis-wrapped diced cartilage compared to the other interventions. The intervention including fascia-wrapped diced tendon grafts had displayed more fibrosis, fragmentation and collagen fibers, while it showed a lower amount of elastic fiber. There were no significant differences among the intervention in terms of other histological parameters.

Conclusion

Tendon autografts may be a good option for dorsal augmentation rhinoplasty as they are easily harvested and have minimal donor site morbidity. Dermis autograft usage is more advantageous than fascia usage in terms of accessibility and convenience.

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Funding

This study was funded by the Scientific Research Projects Directorate of Dicle University to meet the cost of New Zealand white rabbits and laboratory expenses.

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Authors and Affiliations

  1. Department of Plastic Reconstructive and Aesthetic Surgery, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey

    Mehmet Ozdemır

  2. Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Dicle University, Diyarbakir, Turkey

    Mehmet Fatih Akkoç

  3. Department of Histology and Embryology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey

    Selcuk Tunık

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  1. Mehmet Ozdemır
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Contributions

MFA, MO and ST performed measurements and manuscript preparation. ST and MFA were involved in study design, performed measurements and manuscript preparation. MFA and MO contributed to study design, statistical analysis and manuscript preparation. ST, MFA and MOwere involved in study design and manuscript preparation

Corresponding author

Correspondence to Mehmet Fatih Akkoç.

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Competing interests

The author declared that there is no conflict of interest.

Ethics Statement

Before starting the study, necessary ethical approvals were obtained from the Animal Experiments Local Ethics Committee of Dicle University (Date: 24/02/2021, Protocol No: 2021/14). The study was conducted at the Health Sciences Application and Research Center at Dicle University in compliance with the standards recommended by the European Council regarding experimentation on animals.

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Ozdemır, M., Akkoç, M.F. & Tunık, S. Investigation of Two New Grafting Techniques for Dorsal Augmentation Rhinoplasty: An Experimental Study with New Zealand White Rabbits. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-03949-8

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