Caterpillar Graft for Secondary Rhinoplasty

Background: Different autologous materials are recently used in the purpose of augmentation of the nasal dorsum. Despite the benefits and drawbacks, nasal reconstruction with autologous tissue remains a better method for excellent results and lower morbidity rates. Methods: The authors harvested conchal cartilage from the ears and use it after dicing. The superficial temporal fascia was harvested from the temporal region. Diced cartilage was wrapped with superficial temporal fascia, making a roll. After creating a cavity in the nasal dorsum, the combined roll graft was inserted over the nasal dorsum in a “caterpillar” fashion. The authors have operated on 18 patients of secondary nasal deformity cases. Results: The results were excellent in most of the cases. This procedure presented many advantages: optimum nasal contouring, satisfactory volume for the nasal dorsum, and with low rates of infection and exposure. Conclusions: Nasal deformities were reconstructed using crushed cartilage harvested from the concha and enclosed in temporal fascia. This procedure could provide more psychologic comfort and long-lasting appearance.