Fat Grafting for Revision Rhino - Pros and Cons? Is it safe?

They are disastrous, should never be used, they displace, extrude, get
infected, etc... and look artificial... no one experienced rhinoplasty
surgeon may use them; the name "rhinoplasty" when silicone and other rubbish from artificial
origin is used, that is agains the historical and best practices in
nasal surgery. Sorry to be straight, change surgeon to one who knows how
to do a revision surgey with your own tissues only.Never ever such alloplastic materials should be used in cases like yours or others, the consequences might be catastrophic.I recommend you find a good rhinoplasty surgeon, and not a "nose implantologist".If there is infection or extrusion (somethin common if not the universal rule with implants in the nose), the removal must be IMMEDIATE to avoid damage to skin, do change surgeon and seek better opinion asap. Not only that, the infection/extrusion CONTRAINDICATES ANY KIND of procedure on the nose for about one year as minimum.And finally, of course fat grafting IS NOT indicated in nasal surgey, in no textbook, manual or school of real rhinoplasty surgeons. To rebuild a nose the options are cartilage grafting from ears and septum, eventually and as secondary option bone graft.Do seek much much better opinions.

Hi Sarah, thanks for the question. If infected, the safest thing to do may be to remove the implant and wait for the infection to clear before performing a reconstruction. My preference for augmenting the bridge is to use the patient's own cartilage, as it looks and feels more like a natural nose. The first choice is cartilage taken from the septum, inside the nose. If this cartilage has already been removed, ear or rib cartilage may be necessary in revision cases. I'm not sure if you are referring to fat transfer (liposuction from the body and injection in the face) or dermal fat grafting, but in either case, you may be better off going the cartilage route. I've seen patients with dermal fat grafts placed by other surgeons and the nose tends to look soft and doughy rather than refined and natural. Of course, your surgeon may be experienced in the use of fat grafts for the nose, but it's not my preference. The best advice I can give you is to consider additional consultations with revision rhinoplasty specialists before moving forward.  Best regards,Dr. Mehta

Dear sarah001It is standard practice to replace nasal dorsum with a solid replacement. Autogenous tissue, such as septal, ear or rib cartilage is best, when not available, or due to donor site morbidity, silicone or other synthetic implants work well. In my experience, fat grafting requires soft vascular beds and an infected nasal dorsum is likely to respond very poorly to fat grafting. In all fairness, I have never attempted fat grafting to the nasal dorsum for volume loss because it doesn't make good technical sense to me. Any irregularity would be easily apparent and if you are lucky enough for the graft to take evenly it might look bumpy when you gain or loose weight. A good alternative might be temporalis fascia with or without some cartilage grafts.