The Effect of Autologous Fat Grafting on Edema and Ecchymoses in Primary Open Rhinoplasty

Aesthet Surg J. 2020 Mar 23;40(4):359-366. doi: 10.1093/asj/sjz075.

Abstract

Background: Autologous fat is a safe and effective soft tissue filler. Recent evidence also suggests improved wound healing and immune modulation with fat grafting.

Objectives: The aim of this study was to describe a novel technique utilizing fat grafting during primary open rhinoplasty. We hypothesize a more rapid resolution of bruising and edema.

Methods: Patients who underwent rhinoplasty were reviewed and compared by presence or absence of concurrent fat grafting. Three-dimensional images were analyzed employing Mirror (Vectra, Canfield Scientific, NJ). Ecchymoses were outlined utilizing a magnetic lasso followed by an area measurement. Volumetric edema measurements were also taken and assessed. Edema and ecchymosis were measured at 2 and 6 weeks postoperatively. Statistical significance was defined as P < 0.05.

Results: Sixty-two patients were included. Thirty-three patients (53.2%) received autologous fat grafting and 29 (46.8%) did not. Age, gender, surgical approach, and osteotomy distribution were similar between the groups. The fat grafted group showed 7.29 cm2 fewer ecchymoses (P < 0.001) and 0.73 cc less edema (P = 0.68) in the early postoperative interval. Six weeks postoperatively, the fat grafted group showed 1 cc less edema (P = 0.36) with negligible differences in bruising.

Conclusions: Autologous fat grafting is a useful adjunct to rhinoplasty and is associated with significantly fewer ecchymoses in the acute postoperative period.

MeSH terms

  • Adipose Tissue
  • Ecchymosis* / etiology
  • Edema / etiology
  • Humans
  • Osteotomy
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Rhinoplasty* / adverse effects