Microautologous Fat Transplantation for Primary Augmentation Rhinoplasty: Long-Term Monitoring of 198 Asian Patients

Overview

Raising the bridge of the nose is usually done with cartilage or a synthetic implant. This study tested transplanting the patient's own fat instead, placed in very small parcels using a dedicated injection device. Patients were reviewed retrospectively with satisfaction scores and before and after photographs.

Sections of note

• 198 patients had first-time augmentation rhinoplasty using microautologous fat transplantation. Mean age 45.5 years.
• Fat was harvested by liposuction, then processed and refined by centrifugation before transfer.
• Small parcels of purified fat were placed into the nasal bridge with a dedicated device.
• Mean operating time was 25 minutes per session. Patients underwent one to three sessions, with a mean 3.4 mL of fat per session, range 2.0 to 5.5 mL.
• Mean follow-up was 19 months, range 6 to 42 months.
• 125 of 198 patients (63.1 percent) said they were satisfied. There were no major complications. Level of evidence 4, therapeutic.

What it means for a patient

• Fat transfer avoids both a synthetic implant and a cartilage harvest, and the procedure took about 25 minutes.
• Most patients needed more than one session, since transplanted fat is partly reabsorbed.
• Satisfaction was 63.1 percent, lower than typically reported for implant or cartilage augmentation, so the trade-off is a less invasive procedure for a less certain result.
• Retrospective, single centre, no comparison group, and the abstract does not state how much of the added height persisted at final follow-up.

Why this paper matters

Implant complications drive much of the revision burden in Asian augmentation rhinoplasty, so a method using the patient's own tissue addresses a real problem. Nearly 200 patients followed to an average of 19 months is a substantial series for a fat transfer technique. What is unanswered is how much volume survives long term and how the result compares directly with implants.

Terms

• Augmentation rhinoplasty: nasal surgery that adds material to build up the nose.
• Autologous fat transplantation: moving the patient's own fat from one part of the body to another.
• Liposuction: suction removal of fat, here used to harvest the graft.
• Centrifugation: spinning at high speed to separate and purify the fat.
• Nasal dorsum: the bridge of the nose.
• Likert scale: a numbered rating scale used to record satisfaction.