Supramastoid Fascia as an Autologous Donor Site Alternative for Moderate Dorsal Augmentation: A Multicenter Prospective Study.

Abstract

Autologous fascia has been widely applied in rhinoplasty, yet prospective data on the supramastoid donor site remain scarce. This region provides a dense, pliable fascial layer with concealed scarring, potentially suitable for moderate nasal dorsal augmentation. To prospectively evaluate the clinical outcomes, long-term stability, and patient satisfaction of supramastoid fascia as an autologous graft material for dorsal augmentation. This multicenter observational study enrolled patients between June 2022 and April 2024. Dorsal projection and fascial thickness were measured by 3D photogrammetry and 15-MHz ultrasound at 1, 6, 12, 24, and 36 months, with patient satisfaction assessed using the FACE-Q Rhinoplasty Module. Longitudinal changes were analyzed using repeated-measures ANOVA and linear mixed-effects models. Among 73 patients, 67 (91.8%) completed ≥12 months of follow-up; 65% were observed beyond 24 months and 19% to ≥36 months. Dorsal height increased significantly at 1 month and remained stable through 36 months (P > 0.05 after 12 months). Mean resorption rate was 8.6 ± 3.7% at 12 months and 9.4 ± 4.1% at 36 months. FACE-Q satisfaction scores remained >80 across all domains without late decline. No graft displacement, irregularity, or donor-site morbidity was observed. The supramastoid fascia is a practical, minimally invasive autologous donor-site alternative for moderate dorsal augmentation, showing stable projection and high satisfaction through 36 months. Longer follow-up and multi-ethnic cohorts are warranted.