The Use of Acellular Human Dermis as a Dorsal Camouflaging Graft in Rhinoplasty

Melancon CC, Challapalli S, Kridel RWH.

What this paper says

In 91 patients over 20 years, processed donor skin (acellular human dermis) used to thicken thin or scarred nasal skin caused contour problems in 1%, resorbed in 3%, and became infected in 4% (all resolved with oral antibiotics), at a mean 3.8 years of follow-up.

Overview

Acellular human dermis (AHD) is donor skin stripped of cells, used to pad thin skin so grafts and irregularities do not show. Kridel's group retrospectively reviewed 91 rhinoplasties from 2000 to 2020 in which AHD was used as a camouflage graft, describing the technique and recording complications, revisions and long-term outcomes.

Sections of note

91 patients; 70 (77%) were revision cases with thinned, scarred skin.
Contour problems attributable to AHD: 1%.
Resorption of the AHD: 3%.
Postoperative infection: 4%, all resolved with one course of oral antibiotics.
Mean follow-up 3.8 years.

What it means for a patient

If previous surgery has left the nasal skin thin enough to show every edge underneath, a layer of processed donor dermis can be placed to soften the look.
In this long series the material rarely caused problems and mostly did not disappear.
It is a donor product; infection risk exists but was low and treatable here.

Why this paper matters

It is the longest-term series on AHD as nasal camouflage, from a high-volume revision surgeon. Limits: retrospective, single surgeon, no comparison with fascia or other camouflage materials.

Terms

Acellular human dermis (AHD): donor skin processed to remove cells, leaving a collagen scaffold (e.g. AlloDerm).
Camouflage graft: material placed under the skin to hide irregularities rather than change structure.
Skin envelope: the skin and soft tissue over the nasal framework.
Resorption: absorption of the graft by the body.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Acellular human dermis (AHD) has many uses in rhinoplasty, but its long-term use as a camouflaging graft has not been adequately described. Objective: To measure the long-term outcomes (infections/contour irregularities) of AHD used as a camouflage graft in rhinoplasty. Methods: A retrospective study of 91 patients…”

Excerpt; the full abstract is on PubMed.