Q. What is the difference between autologous dermis and donated dermis in a first nose surgery? Is the absorption rate different as well?

Hello. I am Director Seo Chan-eol of AB Plastic Surgery.

I’ll answer the questions many of you have been asking about rhinoplasty!

Q. What is the difference between autologous dermis and donated dermis in a first nose surgery? Is the absorption rate different as well?

When performing nose surgery, if the skin has become thin, the thickness of the skin is reinforced through autologous or donated (artificial) dermis. Today, I’ll explain these dermal materials and the differences between them.

Skin includes the epidermis, dermis, and skin appendages such as hair follicles, sweat glands, and sebaceous glands. The epidermis, which serves as a protective barrier on the outermost layer, is made up of multiple layers of keratin. The dermis is a thick layer of connective tissue beneath the epidermis and is composed of collagen, elastin, and more.

When undergoing rhinoplasty, the skin at the tip of the nose is supported and lifted with tissue from the body, and the skin on the bridge is stretched as the structure is filled with tissue from the body or a silicone implant. As the tip is lifted and the bridge is filled, the skin goes through a process of being pulled and stretched.

If the skin was originally thin, or has become thin due to a previous surgery or procedure, or if it has been expanded excessively, the implant or cartilage may show through or feel too sharp. To reduce issues such as the skin becoming thinner from pressure, appearance of implant visibility, or palpability, or when a softer, rounder look is preferred, the dermal layer of the skin is reinforced.

To reinforce the dermal layer, there are autologous dermis and donated dermis. First, autologous dermis refers to reinforcement using tissue taken from one’s own body. If rib cartilage is harvested, it can be taken additionally from the incision site and used. If rib cartilage is not harvested, it can be taken from the fold behind the ear. Because it is one’s own skin tissue, it has a high rate of survival and a low rate of absorption, and its thickness and length can be adjusted, making it a good material. However, it may be limited when a large amount is needed, or due to scarring or skin that is already too thin.

Donated dermis is a type of artificial dermis made by processing skin from a cadaver. It can be used when a large amount is needed or when autologous harvesting is limited. Compared with one’s own skin tissue, it is harder to adjust the thickness and has a higher absorption rate, but it can still adequately reinforce the dermal layer and perform the necessary role. It does not specifically become a major cause of inflammation, so it can be considered a good material.

Because the appropriate material differs depending on the purpose of use, the required size and thickness, and the condition of the original skin, it is best to discuss this in advance with a specialist during the surgical planning stage after sufficient consultation. If you have any other questions, please leave a comment.

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