[Column] Is rhinoplasty with autologous dermis better than using an implant?

Hello. This is AB Plastic Surgery.

Today, I’d like to talk about the advantages and disadvantages of rhinoplasty using autologous dermis.

First, if you look at the structure of the skin, it is composed of the epidermis and dermis, and the layer beneath the skin consists of subcutaneous fat and the superficial fascia.

The tissue usually used in rhinoplasty is the dermal layer.

However, because the thickness of the dermis differs depending on the person or the harvest site, in some cases the entire dermis + subcutaneous fat + superficial fascia layers are harvested together.

The harvest site for this dermis also changes depending on where it will be placed.

Usually, dermis used for the nasal bridge is harvested from the buttock crease, and when used for the nasal tip, it is harvested from behind the ear or from the skin of the buttock.

When dermis needs to be harvested while performing rhinoplasty using autologous rib cartilage, it may also be taken from the skin at the site where the autologous rib cartilage is removed.

The dermis that is harvested and transplanted in this way does not maintain the volume or height it had at the moment of transplantation; it is absorbed.

It is usually absorbed over about 18 months, and the amount is considered to be about half.

Once absorption is complete, the dermis can be regarded as remaining permanently.

However, what must be kept in mind is that the amount absorbed and the period of absorption vary from person to person.

Because of these characteristics of transplanted dermis, clear limitations arise in surgery using dermis.

The first is that it is difficult to predict the exact height after surgery.

Also, because dermis is soft connective tissue, when it is transplanted to the nasal bridge, it may feel blunt rather than slim and well-defined, and may feel soft and flesh-like.

Therefore, if you want major changes such as a high nasal bridge or a defined nasal tip, surgery using autologous dermis is not recommended.

However, if the skin has become thin after multiple revision surgeries, or if there is a risk of complications, we recommend autologous dermis grafting rather than surgery using an implant.

Thank you.