Refinement of rhinoplasty with lipoinjection

Background: The most common aesthetic defects after rhinoplasty are small dorsal irregularities observed mainly in patients with thin dorsal nasal skin. Many techniques have been used in attempts to prevent perceptible irregularities and sharp edges of bone and cartilage in these patients. Adipose tissue transplantation has been used widely in aesthetic surgery as a surgical method to correct surface depression or to augment soft tissue. Recently, this tissue has been considered a potential source of stem cells with regenerative capacity and other benefits. The authors present a simple procedure using lipoinjection of microfat grafts over the osseocartilaginous framework of the nasal dorsum as a routine technique in rhinoplasty. Methods: Open rhinoplasty was performed for all the patients. At the start of the procedure, we aspirated 3 to 5 ml of fat and separated it using the sedimentation method. The fat deposited as sediment (2-3 ml) was injected at the beginning of the procedure, after suture of the incisions and before application of the splint, over the osseocartilaginous framework in the subcutaneous space. The fat acted as a thin layer of soft tissue to thicken the overlying skin and help camouflage minimal imperfections. Results: Between February 2003 and May 2005, 78 rhinoplasties were performed, with injection of autologous fat. Of the 78 patients, 61 were primary rhinoplasties and 17 were secondary rhinoplasties with a follow-up time of 1 to 36 months. No minor irregularities were observed, and the aspect and quality of the skin improved for all the patients. Conclusions: Fat injection into the nose as a refinement of rhinoplasty is a fast, easy, inexpensive procedure for obtaining regular and smooth contours on the nasal dorsum that lasts over time.