Free Diced Dorsal Augmentation (FDDA) rhinoplasty in non-caucasian patients: tips and tricks

Background: Ethnic nose rhinoplasty is one of the most technically and conceptually challenging plastic surgery procedures due to the complex nasal anatomy and aesthetic preferences. The procedure aims to reshape and project the nasal tip, enhance and strengthen the dorsum, and reduce the size of the alar base, approaching Western beauty standards. It requires tip plasty with significative tip re-projection, leading to a typical asymmetry between the new tip and the nasal bridge, requiring dedicated dorsal reconstruction. The aim of this article is to describe our Free Diced Dorsal Augmentation (FDDA) technique for ethnic nose dorsal reconstruction, sharing our tips and tricks. Methods: We retrospectively reviewed patients who underwent FDDA rhinoplasty at our institution in Rio de Janeiro between January 2019 to January 2023, describing our personal technique. The minimum follow-up was 1 year. We assessed procedure related complications, differences in nasal dorsal shape and contour, global symmetry and patients’ satisfaction according to the rhinoplasty outcomes evaluation (ROE) questionnaire. Results: 812 patients including 641 primary and 171 secondary rhinoplasties were included in the study. Complications were minimal, only one patient required revision surgery due to nasal contour asymmetries. Aesthetic results were satisfactory, as assessed by the mean postoperative ROE score. Conclusions: This study has demonstrated that our FDDA approach, employed on several ethnic noses, is a safe and effective procedure, with high patients’ satisfaction. Meticulous intraoperative diced cartilage preparation together with appropriate postoperative pharmacological and physical prevention of inflammation and edema contribute to our long-lasting results. Level of evidence: Level III, therapeutic study.