Camouflage of the nasal dorsum using autologous fatty tissue and plateted rich Fibrin

Introduction A thin skin or scarred soft tissue envelope poses a challenge, particularly in the context of secondary septorhinoplasty (SRP). It can lead to unpredictable scarring, shrinkage and discoloration of the skin. Apart from careful preparation of the soft tissue mantle, there is no gold standard to minimize the above risks. The aim of this study was to create a thin "separation layer" between the nasal bridge and the skin by autologous fat transfer with the addition of platelet rich fibrin (PRF) in order to conceal small irregularities, improve the quality of the skin soft tissue mantle and optimize the mobility of the skin.

Material and methods 21 patients who underwent SRP were included in the study. All patients had either thin skin and/or revision SRP with scarring. Fat was harvested from the periumbilical or the rib region. PRF was obtained by centrifugation of autologous whole blood samples. The macrofat was minced, purified and mixed with PRF. The solid fat/PRF graft was transferred to the bridge of the nose. Postoperative monitoring of graft survival included sonography and magnetic resonance imaging (MRI) of the nose. Furthermore, in vitro analysis of the harvested adipose tissue was performed.

Results In the follow-up after one year, survival of the adipose tissue was demonstrated in all patients in both sonography and MRI control. The in vitro analyses showed interindividual differences in the quantity, size and quality of the transplanted adipocytes.

Discussion The camouflage of the nasal bridge using adipose tissue showed a benefit with regard to the quality of the skin soft tissue mantle. The aim in future would be to be able to draw conclusions about the quality of the adipose tissue to be transplanted based on clinical parameters.

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Artikel online veröffentlicht:
19. April 2024