SpringerLink
Log in

Using Dermofat Grafting in Revision Rhinoplasty

  • Original Article
  • Rhinoplasty
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

For revision surgeries due to complications associated with alloplastic materials, autologous tissues including dermofat are considered. However, graft absorption, sha**, and donor site morbidity remain crucial challenges. This study aimed to present several surgical techniques of dermofat grafting for rhinoplasty to overcome these challenges.

Methods

Patients who underwent autologous dermofat grafting from January 2015 to October 2019 were retrospectively studied, and those who underwent primary rhinoplasty were excluded. The mid-sacral dermis (with the thickest dermal layer) was selected as the main donor site. During dermal harvesting, fat was resected into a wedge shape, to minimize flap tension and dead space risk. A molding technique was applied to improve graft shape and height and minimize graft absorption. Patient records were reviewed for assessing preoperative evaluations, surgical methods, and complications. For evaluating aesthetic outcomes, three rhinoplasty surgeons, blinded to the study purpose, compared preoperative and postoperative photographs.

Results

Among 331 cases undergoing dermofat grafting for revision rhinoplasty, 25 underwent revisions; of these, five, one, and nine cases experienced over-absorption, over-correction, and deviation, respectively. One and eight cases underwent revision due to a widening scar at the dermofat donor site and wound dehiscence, respectively. Notably, one case had inflamed sinus formation.

Conclusions

The advanced dermofat graft technique provided favorable results with selection of appropriate donor site and a dermofat graft with subdermal fat. The application of this molding technique and proper management of donor site ameliorated critical disadvantages, thereby providing a safe and effective alternative for revision rhinoplasty.

EBM Level IV

Rhinoplasty

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11

Similar content being viewed by others

References

  1. Rodman R, Kridel R (2016) A staging system for revision rhinoplasty: a review. JAMA Facial Plast Surg 18:305–311

    Article  Google Scholar 

  2. Kim JH, Song JW, Park SW (2017) Contracted nose correction with dermofat and conchal cartilage. Plast Reconstr Surg Glob Open 5:e1272

    Article  Google Scholar 

  3. Peled ZM, Warren AG, Johnston P, Yaremchuk MJ (2008) The use of alloplastic materials in rhinoplasty surgery: a meta-analysis. Plast Reconstr Surg 121:85e–92e

    Article  Google Scholar 

  4. Hwang K, Kim DJ, Lee IJ (2001) An anatomic comparison of the skin of five donor sites for dermal fat graft. Ann Plast Surg 46:327–331

    Article  CAS  Google Scholar 

  5. Gonzalez R (2004) Augmentation gluteoplasty: the XYZ method. Aesthetic Plast Surg 28:417–425

    Article  Google Scholar 

  6. Willard FH, Vleeming A, Schuenke MD, Danneels L, Schleip R (2012) The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat 221:507–536

    Article  CAS  Google Scholar 

  7. Erdogan B, Tuncel A, Adanali G, Deren O, Ayhan M (2003) Augmentation rhinoplasty with dermal graft and review of the literature. Plast Reconstr Surg 111:2060–2068

    Article  Google Scholar 

  8. Kim HK, Rhee SC (2013) Augmentation rhinoplasty using a folded "pure" dermal graft. J Craniofac Surg 24:1758–1762

    Article  Google Scholar 

  9. Kim HS (2008) Dorsal augmentation in secondary rhinoplasty. J Korean Soc Aesthetic Plast Surg 14:79

    Google Scholar 

  10. Kim YK (1999) Augmentation rhinoplasty using dermofat graft. J Korean Soc Aesthetic Plast Surg 5:33–40

    CAS  Google Scholar 

  11. Sajjadian A, Rubinstein R, Naghshineh N (2010) Current status of grafts and implants in rhinoplasty: part I. Autologous grafts Plast Reconstr Surg 125:40e–49e

    Article  Google Scholar 

  12. Lee PK, Kim YJ, Wee SS, Cho MJ (1991) Treatment of the complications after augmentation rhinoplasty: dermofat graft. J Korean Soc Plast Reconstr Surg 18:697–707

    Google Scholar 

  13. Varadharajan K, Sethukumar P, Anwar M, Patel K (2015) Complications associated with the use of autologous costal cartilage in rhinoplasty: a systematic review. Aesthetic Surg J 35:644–652

    Article  Google Scholar 

  14. Smith OJ, Kanapathy M, Khajuria A, Prokopenko M, Hachach-Haram N, Mann H, Mosahebi A (2018) Systematic review of the efficacy of fat grafting and platelet-rich plasma for wound healing. International wound J 15:519–526

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. April 31 Plastic Surgery Clinic, 707, Nonhyeon-ro, Gangnam-gu, Seoul, Republic of Korea

    Jae Hoon Kim, Hyo Sun Ko & Sung Wan Park

Authors
  1. Jae Hoon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hyo Sun Ko
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sung Wan Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jae Hoon Kim.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was exempted from ethical approval due to its retrospective design, but was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

For this type of study, informed consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, J.H., Ko, H.S. & Park, S.W. Using Dermofat Grafting in Revision Rhinoplasty. Aesth Plast Surg 45, 617–625 (2021). https://doi.org/10.1007/s00266-020-01950-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-020-01950-5

Keywords

Search

Navigation