Objective. To evaluate the effectiveness of contour grafts (fascia or fascial sheath filled with finely chopped cartilage chips) for aesthetic dorsal augmentation, as well as three rib grafts as high expanding grafts and closing graft in combination with contour grafts for reconstructive dorsal augmentation.

Material and methods. We describe two methods of dorsal augmentation. The first one implies exclusively fascia or fascial sheath filled with finely chopped cartilage chips for aesthetic dorsal augmentation (less than 4 mm). The second method involves a combined graft comprising high expanding grafts and closing graft in combination with contour grafts for reconstructive dorsal augmentation (more than 4 mm). We retrospectively analyzed 268 patients who underwent dorsal augmentation between January 2017 and October 2022 (70 months). Step-by-step algorithm was used to achieve necessary nasal dorsum height.

Results. Patients were divided into four groups depending on the type of the graft for dorsal augmentation. Moreover, we divided patients into three groups depending on the type of the contour graft. Increment of nasal dorsum height was achieved in all patients.

Conclusion. Technical improvements including preparation, precise fascial excision or narrow grafting and dorsum fixation have greatly increased predictability of results and improved aesthetic lines of the dorsum after augmentation <4 mm. Combined dorsum augmentation was effective for internal enlargement of the nose and filling of dorsum defects over 4 mm. In our opinion, dorsal augmentation technique provides optimal results due to its versatility.

Keywords. aesthetic augmentation, reconstructive augmentation, fascial graft, high expanding grafts, closing graft