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Facial Plast Surg
DOI: 10.1055/s-0044-1786185
Original Research

Characterization of Fat Used for the Optimization of the Soft Tissue Envelope of the Nose in Rhinoplasty

Katharina Storck
1   Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Rechts der Isar, TU Munich, Munich, Germany
,
Siegfried Ussar
2   Research Unit Adipocytes and Metabolism (ADM), Institute for Diabetes and Obesity at Helmholtz Center Munich, Neuherberg, Germany
,
Sebastian Kotz
1   Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Rechts der Isar, TU Munich, Munich, Germany
,
Irem Altun
2   Research Unit Adipocytes and Metabolism (ADM), Institute for Diabetes and Obesity at Helmholtz Center Munich, Neuherberg, Germany
,
Fiona Hu
2   Research Unit Adipocytes and Metabolism (ADM), Institute for Diabetes and Obesity at Helmholtz Center Munich, Neuherberg, Germany
,
Amelie Birk
1   Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Rechts der Isar, TU Munich, Munich, Germany
,
Johannes Veit
3   Praxis für Nasenchirurgie München, Munich, Germany
,
Milos Kovacevic
4   HNO-Praxis Hanse-Viertel, Hamburg, Germany
› Author Affiliations Funding The authors wish to acknowledge financial support received from Legerlotz Foundation.
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Abstract

Septorhinoplasty (SRP) is one of the most common aesthetic procedures worldwide. A thin or scarred soft tissue envelope, especially in the context of secondary SRP, can lead to unpredictable scarring, shrinkage, and discoloration of the skin. Other than the careful preparation of the soft tissue mantle, no gold standard exists to minimize the above-mentioned risks. Our aim was to create a thin “separation layer” between the nasal bridge (osseous and cartilaginous) and the skin envelope by autologous fat transfer with the addition of platelet-rich fibrin (PRF) to conceal small irregularities, to improve the quality of the skin soft tissue mantle, and to optimize the mobility of the skin. We report 21 patients who underwent SRP on a voluntary basis. All patients had either thin skin and/or revision SRP with scarring. Macroscopic fat harvested from the periumbilical or rib region was minced and purified. PRF was obtained by centrifugation of autologous whole blood samples and mixed with the fat to form a graft, which was then transferred to the nasal dorsum. Postoperative monitoring of graft survival included sonography and magnetic resonance imaging (MRI) of the nose. The harvested adipose tissue was also analyzed in vitro. In the postoperative follow-up after 1 year, survival of the adipose tissue was demonstrated in all patients by both sonography and MRI. The in vitro analysis showed interindividual differences in the quantity, size, and quality of the transplanted adipocytes. Camouflage of the nasal bridge by using adipose tissue was beneficial for the quality of the skin soft tissue mantle and hence represents a good alternative to known methods. Future aims include the ability to assess the quality of adipose tissue to be transplanted based on clinical parameters. Level of evidence: N/A.

Keywords

rhinoplasty - revision rhinoplasty - nasal dorsum - platelet-rich fibrin - fat transfer


Publication History

Article published online:
30 April 2024

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