What is your opinion about using ADM (Acellular Matrix Dermis) for mild nasal dorsum augmentation of 1mm?

Question

I had a revision rhinoplasty 18 months ago, I had a very slow frustrating healing time with my oily thick skin and unfortunately ended up with a supra tip fullness. My tip is well supported and the conclusion of my last review is that my dorsum is slightly low and needs augmenting. Surgeon has suggested ADM under local as I only need a small degree of augmentation of 1mm. Is ADM a good choice in mild augmentations? Is it durable? Whats the risk of resorption? Will the dorsum feel hard or squashy?

Steven M. Denenberg, MD · Answer

Of course, I haven't seen your photos, and I don't know your entire history, But even when considering a primary rhinoplasty, 1mm is not much change, and might well not be worth the risk.After 18 months of frustrating slow healing with persistent swelling and oily skin and the certainty of another round of excess swelling and slow healing, it doesn't make sense to me to do another operation to get only 1mm of elevation. What if, after 2 years of waiting for the swelling to go down, you find that all of the graft didn't take, and you still need another 1/2 mm of augmentation? My two cents.

Daniel Greenwald, MD (in memoriam) · Answer

Without photos it is hard to evaluate your question. Supra-tip fullness is not usually treated with dorsal augmentation unless the dorsum has been over-reduced.ADMs are safe and effective but perhaps not as durable as native cartilage grafts.  Review all the options with your surgeon.  If he or she has had only limited experience with tertiary rhinoplasty you may want to get a second opinion. If you elect to have the ADM placed it will be soft and natural and should not cause long term complications.

What is your opinion about using ADM (Acellular Matrix Dermis) for mild nasal dorsum augmentation of 1mm?

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What is your opinion about using ADM (Acellular Matrix Dermis) for mild nasal dorsum augmentation of 1mm?

Answers (2)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.