10.1.13

Fat Assisted Rhinoplasty



Fat deemed liquid gold in aesthetic medicine/sugery has found yet another role in enhancing facial contours. Fat assisted nose jobs are going to get in demand soon.

A recent study suggesting: “Fat grafting can play a role in primary rhinoplasty” was presented at the American Society of Plastic Surgeons (ASPS) annual conference in New Orleans.

In the study, 59 patients underwent primary nose reshaping with fat grafting for nasal volume restoration and contour adjustment. Fat grafting was repeated one to three times in various anatomical areas including the nasal tip, bridge, and base, and the forehead for projection. Twelve nose reshaping patients had fat grafting alone, while 47 patients had combination fat grafting/traditional nose reshaping. Improvement was observed in those who had only fat grafting, but was more effective when the defect is more planar. Thirty-five of the patients who had combination fat grafting/traditional nose reshaping saw significant improvement and were very pleased with their results.

Fat grafting is usually a tool used in revision nose reshaping procedures on patients who were unhappy with the results of their initial procedure. In this study, fat grafting was utilized solely or in combination for primary nose reshaping and results showed that when used with traditional nose reshaping techniques, fat grafting allowed for minimized dissection and improved skin quality.

Important Clarification Point: Fat grafting alone may not be appropriate or the correct course of action for every nose reshaping patient. Volume shifts due to gravity may occur in some cases, though it can be avoided by using specific external splints in the early postoperative period.

Utilizing autologous fat to enhance the nose bridge might be a good choice for those who are against foreign object implants but still want a rhinoplasty. Although fat injection rhinoplasty results are permanent, when thinking of autologous fat injection for rhinoplasty, people should take individual fat re-absorption rate into consideration. Since accurate nose bridge height is not as easily assessed as nose implant of silicone or other materials.

In the initial stage post fat transplant some of the fat transferred into the treated area may be absorbed by the receiver’s body. After 3 months following the surgery, the left fat will stay in the treated area forever since it has built up its own supply net. Second injection can be performed 3 months after to increase the nose bridge height again. Of course, people can still adjust the height in the future with HA filler or fat injection.

Since it’s your fat, the touch of the treated area is as natural as your own nose tissue. Fat injection is a perfect choice for people who advocate natural beauty and dislike prosthesis been noticed by others.
 
Applicable Areas

Fat injection for rhinoplasty can be applied on nose bridge and nose tip together with a complete nose adjustment. Nose reshaping combined with Scaffolds (Misko) nose tip sculpting can create an excellent result.

Revision Fat Injection Treatment

It's important to remember that some of the transplanted fat may be absorbed by the receiver’s body. The left fat after 3 months will survive permanently in the treated area. Therefore, for people who want a higher nose bridge than the final result of his/her first fat injection, a 2nd injection is recommended to obtain the optimal effect. In addition, fat injection could be an option for people who have already had implant or artificial skin in their noses yet still want to increase the height.

Fat Injection Advantages

Fat injection is performed with local anesthesia. Plastic surgeon will aspirate fat from the buttock, abdomen, or thigh first and then use centrifuge to extract purified fat for nose injection.
Because of the injection (no incision), there is minimal swelling and bruising after the treatment. Recovery is also very fast and patients can return to work right after the treatment.
Although there are not many post surgical care instruction for fat injection rhinoplasty, touching with great power should be avoided.
Generally speaking, autologous fat injection is so far the most gentle method of rhinoplasty with much less side effects.

I have personally injected few patients with great results and am so glad to find the validation of the procedure in the acclaimed medical/surgical circles.