Autologous Fat Injection for Rhinoplasty: A Systematic Review of Satisfaction, Reinjection and Fat Retention

Zeng H, Tang S.

PubMed 39751904 Publisher (DOI)Free full text (PMC)

What this paper says

Across 11 studies and 849 patients, fat injection to the nose gave about 81% satisfaction, but only around half the fat survived at 3-6 months and at least 19% of patients needed re-injection within a year.

Overview

Injecting the patient's own fat is proposed as an alternative to filler or surgery, but fat resorbs. The Chinese authors searched PubMed, Web of Science, Embase and Cochrane for studies of fat injection for nasal augmentation, tip work or revision and extracted satisfaction, retention, complications and re-injection rates.

Sections of note

11 studies, 849 patients, all with at least one fat injection.
Satisfaction in 9 studies (820 patients) ranged 63-100%, about 81.2% overall.
Fat retention: under 50% at 6 months; 44.54% (range 21-74%) at 3 months; 50.5% (SD 7.0) at 6 months.
At least 158 of 849 (18.61%) had one or more repeat injections; at 1 year the re-injection rate was at least 19.27%.
Complications uncommon; swelling and bruising most frequent. Level of Evidence III.

What it means for a patient

Fat is the patient's own tissue and avoids synthetic filler, but half of it disappears within months.
Expect to need at least one further session, and possibly more, to hold the result.
Fat cannot provide structural support; it is a volume and camouflage tool.

Why this paper matters

It pools the retention and re-injection data that individual fat-grafting papers tend to underplay. Limits: 11 heterogeneous studies, only three measured retention, varied techniques.

Terms

Autologous fat injection (lipofilling): transferring the patient's own fat by injection.
Fat retention: the proportion of injected fat still present after healing.
Resorption: absorption of the graft by the body.
Augmentation rhinoplasty: adding volume to the nose.

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

Abstract

Background: Autologous fat injection has been proposed as a potential alternative to traditional rhinoplasty. However, the technique has been criticized for its disappointing retention and the potential complications associated with underfilling.

Objective: To summarize data on patient satisfaction, retention, complications and reinjection to provide a reference for fat injection for rhinoplasty.

Methods: Literature search was conducted on four databases (PubMed, Web of Science, Embase and Cochrane Library) using the keywords "rhinoplasty", "nasal tip", "nasal augmentation", "augmentation rhinoplasty", "revisional rhinoplasty" and "nasal revision" in conjunction with "fat", "lipofilling", "lipoinjection" and "adipose graft". Under eligibility criteria, two reviewers conducted an examination of each potential study.

Result: Eleven studies with a total of 849 patients were included in the systematic review and all patients received at least one fat injection. In nine studies that evaluated patient satisfaction, a total of 820 patients exhibited an high satisfaction ranging from 63 to 100% (approximately 81.2%). Complications associated with fat injection are uncommon, with edema and bruising being the most frequently reported. Three studies measured fat retention, which were < 50% (at 6 months after injection), 44.54% (range 21-74%) (at 3 months after injection) and 50.5% ± 7.0% (at 6 months after injection). A minimum of 18.61% (158) of the 849 patients enrolled underwent one or more injections. At 1-year follow-up, the reinjection rate is at least 19.27%.

Conclusion: Autologous fat injection is safe and effective for rhinoplasty. The resorbability of fat requires additional injections in certain noses where deformities are evident.

Level Of Evidence Iii: 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).