Autologous Fat Grafting in Primary Open Rhinoplasty
Kyle Gabrick, MD, Marc Walker, MD, Scott Persing, MD, Derek Steinbacher, DMD MD.
Yale University, New Haven, CT, USA.
BACKGROUND: Autologous fat is a safe and effective soft tissue filler. Recent investigation has been aimed at autologous fat grafting's ability to enhancing tissue potential and immune modulation. The chief aim of this study is to describe a novel technique of fat grafting in primary open rhinoplasty which we hypothesize is resulting in a more rapid resolution of bruising and edema. METHODS: Patients undergoing rhinoplasty at Yale New Haven Medical Center were reviewed. 3-D images were acquired utilizing a Vectra 3-D camera (Canfield Scientific, NJ). All measurements were performed with Mirror (Canfield Scientific, NJ). Ecchymoses were outlined utilizing a magnetic lasso followed by an area measurement. Edema was measured by subtracting the post-operative image from the pre-operative image excluding the nose and mouth from the region of interest. Edema and ecchymosis were measured at 7-10 day and 4-6 week intervals. Significance is defined as p=0.05. RESULTS: Sixty-two patients were included in our retrospective review. 33 patients (53.2%) received autologous fat grafting and 29 (46.8%) did not. Age, gender, surgical approach, and osteotomy distribution was similar between the groups. In the 11 ± 4 day post-operative time interval the fat grafted group showed 0.6cc less edema, (p=0.65) and 6.7cm2 fewer ecchymoses (p=0.05). In the 54 ± 21 day post-operative interval, the fat grafted group showed 1cc lower amount of edema (p=0.64) and 0.5cm2 fewer ecchymoses (p=0.42). CONCLUSIONS: Autologous fat grafting is a useful adjunct procedure to rhinoplasty associated with a significantly lower amount of ecchymoses in the acute post-operative period and a lower amount of edema and ecchymoses four to six months following surgery.
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