A Fascia-Cartilage Hybrid Tip Graft for Nasal Tip Refinement

BACKGROUND: Rhinoplasty and particularly tip refinement, is complex and prone to revision, especially in thin-skinned patients. To address these issues, the senior author developed a fascia-cartilage hybrid tip graft (FCHTG) combining crushed lower lateral cartilage with superficial mastoid fascia. This autologous, moldable, and pliable graft provides both support and contour refinement with minimal donor-site morbidity. This study evaluates the surgical outcomes of FCHTGs for nasal tip contouring in primary and revision rhinoplasty. METHODS: A retrospective review was conducted of all open rhinoplasty cases performed by a single surgeon from May 2021 to May 2024. Patients who underwent rhinoplasty with use of the FCHTG with a minimum 12-month follow-up were included in the study. Outcomes assessed included rate of post-operative infection and revision surgery. RESULTS: A total of 1,418 patients (90.9% female; mean age 31.4 years) met inclusion criteria with a mean follow-up period of 20.4 months. The overall infection rate was 1.8% (n = 17), with 2 patients requiring operative intervention related to infection. The revision surgery rate was 1.2% (n = 15), with the most common reason for revision being over-projected tip (n = 11). CONCLUSIONS: The FCHTG is a safe, autologous grafting option for nasal tip contouring, providing structural support and improved aesthetics with minimal donor site morbidity. It demonstrates low complication and revision rates, making it particularly advantageous in complex or revision rhinoplasty cases, especially in patients with thin or scarred skin.