[Duhan Plastic Surgery Face Autologous Fat Grafting] - [Nose Fat Grafting]

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Nose fat grafting

The biggest advantage of fat grafting is

that the procedure is simple

and there are almost no side effects.

If you feel burdened by surgery using implants, or if you need to return to daily life immediately after the procedure,

nose rhinoplasty can be performed with micro fat grafting. ^^

In which cases can nose rhinoplasty be performed using fat grafting?

Fat grafting can be applied when the nasal bridge is low and only a slight increase in height is desired.

▷ When the alar area is fine but only the nasal bridge is low

▷ When the glabella area (between the eyebrows) is low

▷ When the nose appears slightly crooked

▷ When there is an indented scar on the nasal bridge

▷ When there is indentation of the nasal bridge (saddle nose) or a curve

▷ When the border line becomes visible after inserting an implant such as silicone and needs to be softened

There are methods to raise the nose using implants such as silicone or Gore-Tex, but when raising the nose with autologous fat grafting, the advantages are that you can return to daily life immediately, there is little swelling and bruising, and because your own tissue is used, side effects and resistance are minimal.

When raising the nose with fat, the indications must be carefully selected, and the procedure should only be performed in cases where a good result can be expected.

There are also cases treated with fillers (Artecoll, Restylane, Aquamid), but fillers are products that should not be used for the purpose of raising the nose.

Fillers should only be used to correct fine wrinkles around the eyes, forehead wrinkles, or small indented scars.

Injecting filler into the nose is a procedure that does not suit its intended purpose at all, and because there is a risk of side effects such as skin necrosis or inflammation, the procedure should be approached with caution.

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

Fat grafting method for rhinoplasty

Usually, fat is harvested from the lower abdomen. The reason the lower abdomen is preferred is that fat can be harvested easily, and there is less swelling and bruising, allowing for a faster return to daily life and recovery.

If there is not much fat in the lower abdomen, it is sometimes harvested from the thighs.

Usually, about 40 to 60 cc of fat is collected in preparation for a second procedure.

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

The largest portion of impurities is local anesthetic, followed by oily components mixed into the fat cells.

In addition, because serum and a small amount of blood are mixed in, all impurities except the fat cells must be removed.

Removing impurities cannot be done by centrifugation alone; a process to remove oil is added in addition to centrifugation.

Once purification is complete, the fat is transferred into a 1 cc syringe, fitted with a micro fat grafting cannula, and the procedure begins.

We use the micro needle (micro graft cannula) developed in-house.

The micro needle is a special graft cannula used only at our clinic, enabling ultra-precise grafting.

The procedure is performed by inserting a needle through the tip of the nose, and usually about 1 to 2 cc of fat is grafted.

Examples of fat grafting in rhinoplasty

Cases suitable for nose fat grafting

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

First, the skin must have a certain thickness, and the nasal skin must also have a certain degree of flexibility for the fat to take.

When raising the nasal bridge with nose fat grafting, the usual amount is about 3 mm, and the procedure should be planned with a second session in mind.

Conversely, in cases where the skin is thin, firm, and not flexible, even if the procedure is performed, all of the fat may be absorbed and there may be almost no effect.

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

Cases where nose fat grafting is difficult

① Cases where additional augmentation is desired while silicone or another implant is already in place Fat cannot take on top of silicone. However, fat grafting is possible to soften the border line at the edge of the silicone.
② Within 3 months after removal of silicone or another implant If the capsule surrounding the silicone has not dissolved, the fat will all be absorbed even if grafted. Therefore, after implant removal, grafting is possible only after at least 3 to 6 months.
③ When the skin on the nasal bridge is thin and firm For fat to take, blood circulation must be good and the pressure from the skin must be low. Thin, firm skin has poor blood circulation and strong compressive pressure, so the fat is crushed and melts away.

What are the advantages of rhinoplasty (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 performed without making an incision in the skin, the burden of surgery is low.

4. Unlike surgery, there is no need to secure the area 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 your own tissue is used, natural augmentation is possible.

Progress immediately after nose rhinoplasty with fat grafting

Immediately after the procedure, the nasal bridge becomes more raised than expected, then gradually settles down.

In most cases, there is little swelling or bruising, so most people can return to their daily routine right away.

The result continues to settle for 3 to 6 months, and when it has fully taken and there are no further changes, a second procedure is performed to raise it further.

What should be kept in mind when performing nose rhinoplasty with fat grafting?

1. Because some of the grafted fat is absorbed, one procedure may be insufficient; in such cases, a repeat procedure is needed after 2 to 3 months.

2. The alar area has thick skin, so it is difficult to create shape with fat grafting.

3. If the nasal bridge is severely low, there are limits to how much the nose can be raised with fat grafting.

Number of nose fat grafting sessions

On average, nose fat grafting can produce satisfactory results after about two sessions.

In some cases, satisfactory results can be achieved with just one procedure; this depends on differences in the individual’s tissue take rate.

The interval between procedures is at least 3 months and up to 10 months, and if you return within 10 months, the fat collected during the first procedure is thawed and used for the repeat procedure.

The lasting effect of nose fat grafting

Some people say fat grafting is ineffective because much of it gets absorbed, but this applies to cases performed at hospitals with somewhat less experience.

When fat grafting is performed correctly and according to the proper principles, satisfactory results can be achieved, and once the grafted 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 fat grafting once or twice can produce a permanent augmentation effect.

Comparison between fat grafting and other augmentation methods

	Fat grafting	Silicone	Filler products
Suitable for	Cases where the nasal bridge is to be augmented naturally	Cases where both the nasal bridge and alar area are to be augmented at the same time	Used for correcting fine wrinkles and should not be used for raising the nose.
Advantages	* Less swelling and bruising.* Immediate return to daily life.* Almost no side effects.* Low resistance because it uses your own tissue.	* A definite 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	Due to take rate, two or more sessions are often needed.	* As a foreign material, there is concern about side effects.* * There may be resistance to a foreign material.* * Swelling and bruising make it difficult to return to daily life immediately.	* Inflammatory reactions may occur due to a foreign-body response.* * Side effects such as skin discoloration or necrosis due to blockage of nasal skin blood vessels may occur.* * If side effects occur, removal is almost impossible.

Nose fat grafting is a procedure intended to naturally augment only the nasal bridge.

In many cases, it is not enough to raise the alar area as well.

When raising the nasal bridge with nose fat grafting, the usual amount is about 3 mm,

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

The take rate of nasal fat is about 50% on average, usually around 30 to 50%,

and a second procedure is often performed after about 3 months.

The reason the take rate is lower than in other areas is because

the skin of the nose continuously presses the fat downward,

causing the fat to be crushed.

Nose fat grafting is mainly applied in cases where only a slight natural augmentation is needed, or when the area between the eyes appears low.

If the nasal bone has collapsed due to severe trauma, or if a nasal bone fracture was not properly treated,

the nose may become crooked.

Director Shin Duhan

http://www.duhans.com

Features and pride of the Duhan Plastic Surgery Autologous Fat Grafting Clinic

1. All anesthesia is performed as local anesthesia (sedation anesthesia).

Local anesthesia is performed together with sedation anesthesia, and the procedure is carried out without any pain during or after anesthesia.

2. We have a systematic and advanced fat grafting system.

We harvest living fat cells and, to increase purity, maximize it through centrifuge purification and removal of unnecessary oil.

Before grafting, we create subcutaneous tunneling in the graft area to secure space for the graft.

We perform precise grafting using micro fat grafting cannulas.

By grafting evenly across multiple layers in a three-dimensional manner, we maximize take rate and create soft contours.

3. We select appropriate and various fat harvesting sites.

The most commonly used site is the lower abdomen. Because pain after the procedure is minimal and swelling and bruising are limited, it is often chosen as the first option.

After the lower abdomen, the inner thighs are selected next, followed by the outer thighs.

If there is not enough fat to harvest from the thighs, the lower buttocks or the sides of the waist may also be used.

There is no fixed answer as to which site has the best fat take rate.

The results are similar, and although the area with the most fat is ideal for harvesting, it is better to decide the harvesting site by considering the amount needed and the patient’s activities after grafting.

4. We maximize the take rate through a two-step purification process of the harvested fat.

Among the impurities in harvested fat, the largest proportion is local anesthetic, followed by oil.

Other impurities include serum and red blood cells.

In the first step, the fat undergoes centrifugation for about 3 to 4 minutes, after which it moves to the second step of oil removal.

Oil is removed manually through a natural absorption method.

Through the second purification process, we obtain nearly 100% concentrated fat, maximizing the effect of fat grafting and increasing the take rate as much as possible.

5. We secure space for fat grafting through subcutaneous tunneling.

Subcutaneous tunneling means creating space in advance in the area where fat will be grafted, and it is an essential process needed for a high take rate and even grafting.

Using a thin probe, the tissue under the skin is moved repeatedly in a fan-like pattern to create space for the fat to be grafted.

The effect of subcutaneous tunneling is to increase the fat take rate and prevent clumping, thereby creating a uniform and soft contour.

6. With three-dimensional micro fat grafting, a soft and even facial contour can be achieved.

Although there are exceptions depending on the area, the standard method of fat grafting is the three-dimensional approach.

Fat is divided into multiple layers and grafted in small amounts evenly across each area.

7. We use micro fat grafting cannulas for precise fat grafting.

In the past, methods using fat injection devices forced fat under the skin with high pressure, which caused various problems.

The absorption rate of fat was high, take was inconsistent, and the contour became uneven; it was also difficult to graft in delicate areas such as under the eyes.

To solve these problems, during fat grafting the fat is transferred again into a 1 cc syringe and grafted into the desired area.

At the Duhan Plastic Surgery Micro Fat Grafting Clinic, we use the micro needle (micro graft cannula) developed in-house.

The micro needle is a special graft cannula used only at our clinic, enabling ultra-precise grafting.

Fat grafting can be performed on the upper eyelids, lower eyelids, forehead wrinkles, glabellar wrinkles, nasolabial folds, and the nasal bridge, making fat grafting possible in almost all cases except fine wrinkles.

8. After fat grafting, molding is performed to create a uniform and soft facial contour.

Immediately after fat grafting, delicate molding is performed so that the grafted fat spreads evenly and creates a soft shape.

Molding is the final step of fat grafting and one of the most important processes.

9. Rapid freezing and sterile storage of the remaining fat make the second procedure easier.

When a second procedure is performed 3 months after fat grafting, additional fat does not need to be harvested again; the fat remaining after the first procedure is used.

The remaining fat after the first procedure is stored after rapid freezing and sterile processing.

During the second procedure, the stored fat is thawed and the treatment can be performed more conveniently.

The storage period for fat is up to 10 months, and if you visit within 10 months, the procedure will be performed using the stored fat.

10. At the Duhan Plastic Surgery Autologous Fat Grafting Clinic, we perform multilayer fat grafting based on more than 20 years of rich clinical experience and expertise.

The key to fat grafting is ensuring that living fat cells can achieve a high take rate.

To increase the take rate, a large amount is not injected into one place; instead, it is evenly grafted across multiple layers.

Between the skin and bone there are multiple tissues such as the fat layer and muscle layer, and the fat must be injected in a multilayer structure without overlap, such as between the periosteum above the bone and between the muscle layers above and below.

Multilayer fat grafting lasts 3 to 4 times longer than conventional methods, and fat survival is also higher.

Fat grafting at the Duhan Plastic Surgery Autologous Fat Grafting Clinic also includes a process called tunneling, which allows the grafted fat to contact the surrounding abundant blood vessels as much as possible so that nutrients can be continuously supplied.

Tunneling means creating spaces for the fat to go under the skin using micro needles; in other words, a space is prepared as if drilling a tunnel, and then the fat is injected, so even after all the fat has been placed, it does not sag downward due to gravity or become uneven.

In addition, a delicate injection method allows for custom design.

Through thorough aftercare after fat grafting, we carefully monitor the progress until the fat has fully taken.

During the follow-up period, if necessary, we strive to minimize dissatisfaction by giving swelling-reduction injections or making shape adjustments and molding.

http://www.duhans.com