Pilot Study: Use of Stem Cell Therapy and Diced Cartilage in Secondary Rhinoplasty Cases Clinical Outcomes: The Golden Turkish Delight

Unlu RE, Ozmut O, Ergani HM, Yasar B, Yildirim F.

PubMed 39444535 Publisher (DOI)Free full text (PMC)

What this paper says

In 30 revision rhinoplasty patients treated with diced cartilage enriched with mesenchymal stem cells, 80 percent showed improvement at about one year while 20 percent were not satisfied.

Overview

The Turkish delight technique wraps diced cartilage in a covering to smooth and augment the bridge, but the graft can absorb over time. The authors added mesenchymal stem cells, cells capable of forming several tissue types, calling the result the golden Turkish delight technique. Thirty patients presenting for revision rhinoplasty were treated and assessed at least nine to twelve months later.

Sections of note

Design: prospective pilot study, 30 secondary rhinoplasty patients.
Satisfaction was evaluated at least 9 to 12 months after surgery, with an average follow up of one year.
Outcome tool: the Global Aesthetic Improvement Scale.
80 percent were rated as improved on that scale.
Approximately 56 percent had both high scale ratings and high satisfaction.
20 percent of patients were not satisfied with the result.
The authors state that the absorption seen with the standard Turkish delight technique may be reduced by this variant.
They also credit fat graft support and stromal vascular fraction as contributing to results.

What it means for a patient

One in five patients was dissatisfied, which is a substantial figure even in revision surgery.
The claim that stem cells reduce absorption is asserted rather than measured. No graft volume or imaging data are reported.
No comparison group received the standard technique, so the added value of the cells cannot be judged.
Limits: 30 patients, single centre, no control group, one outcome scale, and roughly one year of follow up when absorption develops over longer periods.

Why this paper matters

Diced cartilage grafts on the bridge shrink unpredictably, and adding regenerative material is one proposed answer. A pilot study establishes feasibility rather than effect. Whether the added cells change graft survival requires imaging and a comparison group, neither of which is present here.

Terms

Turkish delight technique: diced cartilage wrapped in a covering, used to smooth or augment the bridge.
Mesenchymal stem cell: a cell able to develop into several connective tissue types.
Stromal vascular fraction: a mixture of cells separated from fat tissue, containing stem cells.
Global Aesthetic Improvement Scale: a rating of how much appearance improved after treatment.
Secondary rhinoplasty: surgery on a nose that has already been operated on.
Resorption or absorption: gradual loss of graft volume as the body reabsorbs it.

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

Abstract

Background: Although many techniques in the secondary rhinoplasty field have been developed in recent years, there are debates regarding achieving results with a high satisfaction rate. We aimed to share the surgical use technique in secondary rhinoplasty patients by enriching the Turkish delight technique with mesenchymal stem cells, which we described as the golden Turkish delight (GTD) technique, and the long-term patient satisfaction results.

Methods: The study was planned as prospective research, and 30 secondary rhinoplasty patients who presented to our service for rhinoplasty were included. The GTD technique was applied to these patients. The patient's satisfaction with the surgical procedure was evaluated at least 9-12 months after the surgery, and the Global Aesthetic Improvement Scale (GAIS) was used as a measurement tool.

Results: Of the participants, the satisfaction levels of 30 patients were evaluated with a 1-year follow-up on average, and the rate of those who improved was found to be 80% using the GAIS score. The rate of those with high GAIS scores and those with high satisfaction levels was approximately 56%. Twenty percent of the patients were not satisfied with the result.

Conclusions: When we evaluate the postoperative 1-year results of our patients in terms of satisfaction and complications, we may state that the absorption that may occur in the Turkish delight technique over time could give better results with the GTD technique. In addition to GTD and fat graft support, regenerative medicine products such as stromal vascular fraction are very effective in obtaining favorable results.

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