Autologous Shuffling Lipo-Aspirated Fat Combined Mechanical Stretch in Revision Rhinoplasty for Severe Contractures in Asian Patients

An Y, Wang G, Shang Y, Zhen Y, Li X, Shu F, Li D, Zhao Z, Li H.

PubMed 35606536 Publisher (DOI)Free full text (PMC)

What this paper says

Among 24 patients with severely contracted noses split into three groups of 8, those given both fat injection and manual stretching before revision surgery had the greatest gains in nasal length and tip projection at six months.

Overview

A severely contracted nose is common after previous surgery, and expanding the tight nasal covering during the operation alone is not enough to soften it. Adjuvant treatments including fat grafting and cell injection have been used beforehand to soften that covering. This study combined the patient's own processed fat with manual mechanical stretching as preparation before revision rhinoplasty.

Sections of note

Study of 24 patients with severe nasal contracture; the journal assigns level of evidence IV.
Eight received fat plus manual stretching before revision surgery, the comprehensive therapy group.
Eight received mechanical stretching plus revision surgery, and eight had revision surgery alone.
Follow up was 6 months, with both objective measurement and subjective assessment.
Nasal length, tip projection, nasofrontal angle and nasolabial angle were measured, and complications assessed.
All 24 patients underwent successful revision rhinoplasty.
In the comprehensive therapy group, no patient had a wound infection or a defect in the lining of the columella.
That group had the greatest improvement in nasal length and tip projection, with the nasolabial angle closest to 90 degrees.

What it means for a patient

A contracted nose means scar has tightened and shortened it, usually after implant complications, and the covering must be loosened before it can be rebuilt.
Preparing the tissue beforehand appeared to allow more lengthening and projection at surgery.
Eight patients per group is very small, and the assignment method is not stated.
Follow up was six months, which is short given that contracture recurs over time.

Why this paper matters

Recurrent tightening is why severe contracture is among the hardest problems in revision rhinoplasty. This study tests preparing the tissue before operating rather than only during. Whether the gains hold beyond six months is unknown.

Terms

Nasal contracture: scar tissue tightening and shortening the nose.
Lipo-aspirated fat: fat removed by liposuction and processed for reinjection.
Adjuvant therapy: an added treatment given alongside the main one.
Nasal envelope: the skin and soft tissue covering the nasal framework.
Nasofrontal angle: the angle between the forehead and the bridge of the nose.
Nasolabial angle: the angle between the base of the nose and the upper lip.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

Abstract

Background: A severely contracted nose is a common occurrence. Intraoperative expansion is not sufficient to soften the severely constricted nasal envelope, which poses challenges in revision rhinoplasty. In recent years, adjuvant therapies, including nasal fat grafting and cell component injection, are applied before revision rhinoplasty to soften the nasal envelope. Herein, autologous shuffling lipo-aspirated fat and manual mechanical stretch were combined as adjuvant therapy before revision rhinoplasty.

Methods: A total of 24 patients with severe nasal contracture were included in this study. Of these, 8 received autologous shuffling lipo-aspirated fat and manual mechanical stretch before revision rhinoplasty (comprehensive therapy), 8 underwent mechanical stretch and revision rhinoplasty, and 8 patients underwent only revision rhinoplasty. The objective and subjective outcome assessment was processed in the follow-up period of 6 months. Nasal length, nasal tip projection, nasofrontal angle, and nasolabial angle were measured, and potential complications were assessed.

Results: All 24 patients underwent a successful revision rhinoplasty. In the comprehensive therapy group, no patient had postoperative wound infection and defect of the nasal column mucous. The comprehensive treatment group had the most significant improvement in nasal length and nasal tip projection, and the nasolabial angle was the closest to 90°, which indicated the most effective nasal revision and aesthetic contour.

Conclusions: The adjuvant therapy combines autologous shuffling lipo-aspirated fat and manual mechanical stretch before revision rhinoplasty could effectively improve the surgical outcome and decrease the postoperative complications regarding severe nasal contractures.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).