[Duhan Plastic Surgery Fat Grafting] - [Nose Plastic Surgery Using Fat Grafting]

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Nose Plastic Surgery Using Fat Grafting

Nose fat grafting is

applied when the goal is to naturally augment the nasal bridge.

It is used when there is reluctance toward foreign materials such as silicone,

when one needs to return to social life immediately after the procedure,

or when only a slight augmentation of the nose is desired.

Sometimes, it can also be used to correct a crooked nasal bridge.

Indications for fat grafting nose surgery

Flat nasal tip
When the area between the eyes (between the eyebrows) is low
When the nasal bridge is low
When the nose appears crooked
A depressed bridge (saddle nose) or a bridge with a curve
When a border line is visible after inserting an implant such as silicone and needs to be concealed

There are several methods for raising the nose, including silicone and Gore-Tex.

When the nose is raised with autologous fat grafting,

it has several advantages, such as being able to return to daily life immediately,

having little swelling and bruising,

and using the body's own tissue, which reduces side effects and discomfort toward foreign materials.

As a result, preference for fat grafting is increasing.

When raising the nose with fat,

the procedure should be applied only when the indication is appropriate and a good effect is expected.

In addition, fillers such as Artecoll, Restylane, and Aquamid are sometimes used,

but fillers are products that should not be used for raising the nose.

Fillers should be used only for correcting fine wrinkles around the eyes, fine forehead wrinkles,

and small depressed scars.

Injecting filler into the nose is completely inappropriate for its intended use,

and caution is required because there is a risk of side effects such as skin necrosis or inflammation.

For a natural augmentation effect, fat grafting can be considered one of the good methods.

Fat grafting method for nose plastic surgery

Usually, fat is harvested from the lower abdomen.

The reasons the lower abdomen is a good donor site are

that fat can be collected easily, the fat cells are robust,

there is a lot of fibrous tissue,

and swelling and bruising are minimal, allowing for a faster return to daily life and recovery.

If there is no fat at all in the lower abdomen, fat is sometimes harvested from the thighs.

Usually, about 40 cc of fat is collected in preparation for a second procedure.

Impurities in freshly harvested fat usually account for about 80%.

The largest component of impurities is local anesthetic,

followed by oily components mixed into the fat cells.

In addition, since serum and some blood are mixed in,

all impurities other than the fat cells must be removed.

Removing impurities cannot be done by centrifugation alone;

in addition to centrifugation, a process to remove oil is added.

The purified fat is transferred into a 1 cc syringe,

and the procedure begins after attaching a micro fat grafting cannula.

A micro needle (micro grafting cannula) developed in-house is used.

The micro needle is a special grafting cannula used only at this clinic that allows ultra-precise grafting.

The procedure is performed by inserting a needle through the tip of the nose,

and usually about 1–2 cc of fat is grafted.

Examples of nose plastic surgery using fat grafting

Cases where nose fat grafting is appropriate

Nose fat grafting is not a procedure that can be applied to everyone.

First, the skin must have a certain thickness,

and the nose skin must also have some flexibility for the fat to take.

When raising the nasal bridge with nose fat grafting, it is usually about 3 mm,

and the procedure should be planned with a second session in mind.

On the other hand, in cases where the skin is thin, firm, and not flexible,

there are cases where almost all of the fat is absorbed and little effect is seen even after the procedure.

Whether the procedure will be effective can be checked through a direct examination.

The effect of correcting a low nose with fat grafting

Nose fat grafting is a procedure for naturally augmenting only the nasal bridge.

It is often insufficient for raising the nasal tip as well.

When raising the nasal bridge with nose fat grafting, it is usually about 3 mm,

and this varies depending on the individual's skin thickness and flexibility.

The take rate of nasal fat grafting is, on average, 30–50%, with 50% as the average,

and in most cases, a second procedure is performed after 3 months.

The reason the take rate is lower than in other areas is that the skin of the nose

continuously presses downward on the fat, causing it to be crushed.

Nose fat grafting is mainly applied when the goal is to naturally and slightly augment the nose

or when the area between the eyes appears low.

When the nasal bone collapses due to severe trauma or after a nasal bone fracture accident,

the nose may become crooked if it is not properly treated.

The effect of correcting a crooked nose with fat grafting

When the nasal bone collapses due to severe trauma or

after a nasal bone fracture accident and is not properly treated,

the nose may become crooked.

In many cases, the traditional method is to re-osteotomize and lift the nasal bone,

but because the surgery is too large and burdensome,

a slightly crooked nose can be corrected to some extent with fat grafting as well.

Rather than forcing a more invasive osteotomy,

this procedure is very simple,

so unless the nose is severely crooked,

the nasal axis can be corrected to some extent with fat grafting.

Even in cases where the silicone shifts after silicone augmentation rhinoplasty

and the nose appears crooked, correction is possible with fat grafting.

Fat grafting above the silicone does not take,

but some fat does take at the side border area.

Once the silicone has shifted,

correction is only possible by removing the silicone and reinserting it after 6 months,

so correcting it by replacing the silicone is very difficult and time-consuming,

but when corrected with fat grafting,

correction is done while leaving the silicone in place, so the procedure is simple and effective.

Cases where nose fat grafting is difficult

1. When additional augmentation is desired in a nose that already has silicone or an implant insertedFat cannot take above silicone.However, fat grafting can be performed to remove the border line at the edge of the silicone.
2. Within 3 months after removing silicone or another implantIf the capsule surrounding the silicone has not dissolved, all of the grafted fat will be absorbed.Therefore, after removal of an implant, at least 3–6 months must pass before grafting is possible.
3. When the skin over the nasal bridge is thin and firmFor fat to take, blood circulation must be good and the pressure from the skin must be low.Thin, firm skin has poor circulation and exerts strong pressure, causing the fat to be crushed and absorbed.

Advantages of nose plastic surgery (augmentation) with fat grafting

1. The procedure is simple.
2. Because no foreign material such as silicone is used, there is no concern about side effects.
3. Because the procedure is done without cutting the skin, there is less burden than surgery.
4. Unlike surgery, it does not need to be fixed with tape for several days immediately after the procedure.
5. There is almost no swelling or bruising.
6. You can return to daily life immediately after the procedure.
7. Because the body's own tissue is used, a natural augmentation effect is possible.

Points to note when performing nose plastic surgery with fat grafting ​

◇ Nose fat grafting is not a procedure that applies to everyone, so before treatment, you should receive a consultation to determine whether your nose can benefit from fat grafting and decide whether to proceed.
◇ Nose fat grafting is effective for augmenting the glabella or nasal bridge area, but it is difficult to apply to the nasal tip. Sometimes, if the skin is flexible, an effect reaching the nasal tip can be achieved, but this is not common.
◇ Because the nose has a lower take rate for fat grafting than other areas, a second procedure should usually be considered.

Number of nose fat grafting sessions

Nose fat grafting is performed as few as once and on average about twice.

The interval between procedures is between 3 and 10 months,

and for a repeat procedure, the fat harvested at the time of the first grafting can be thawed and used.

Long-term effect of nose fat grafting

Some people say that fat grafting has no effect because much of it is absorbed,

but if fat grafting is performed accurately, a satisfactory result can be obtained,

and once the transplanted fat takes,

it is no longer absorbed and remains as your own fat tissue for life, making it one of the safest and most effective methods.

On average, receiving two fat grafting sessions can produce a permanent and satisfying augmentation effect.

Comparison of various procedures for nasal augmentation

	Fat grafting	Silicone	Filler products
Suitable candidates	When the goal is to naturally augment the nasal bridge	When the goal is to augment the nasal bridge and nasal tip at the same time	Intended for correcting fine wrinkles and should not be used to raise the nose.
Advantages	* Less swelling and bruising.​* Immediate return to daily life is possible.​* Almost no side effects.​* Because it uses the body's own tissue, there is less discomfort.	* A clear augmentation effect can be achieved.​* Fewer side effects.​* Can be removed easily if undesired.	* There are no advantages for the purpose of nasal augmentation.
Disadvantages	Because of the take rate, more than two sessions are often needed.	* Because it is a foreign material, there is concern about side effects.​* There may be discomfort with a foreign material.​* Swelling and bruising make immediate daily life difficult.	* Inflammatory reactions may occur due to a foreign-body response.​* Side effects such as skin discoloration or necrosis due to vascular occlusion in the nasal skin may occur.​* If side effects occur, removal is almost difficult.

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