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

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BACKGROUND: 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. OBJECTIVES: To prospectively evaluate the clinical outcomes, long-term stability, and patient satisfaction of supramastoid fascia as an autologous graft material for dorsal augmentation. METHODS: 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. RESULTS: 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 > .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. CONCLUSIONS: 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. LEVEL OF EVIDENCE: 2: (Therapeutic) For image description, please refer to the figure legend and surrounding text.

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