Autologous Fat Injection for Rhinoplasty: A Systematic Review of Satisfaction, Reinjection and Fat Retention

Background: Autologous fat injection has been proposed as a potential alternative to traditional rhinoplasty. However, the technique has been criticized for its disappointing retention and the potential complications associated with underfilling.

Objective: To summarize data on patient satisfaction, retention, complications and reinjection to provide a reference for fat injection for rhinoplasty.

Methods: Literature search was conducted on four databases (PubMed, Web of Science, Embase and Cochrane Library) using the keywords "rhinoplasty", "nasal tip", "nasal augmentation", "augmentation rhinoplasty", "revisional rhinoplasty" and "nasal revision" in conjunction with "fat", "lipofilling", "lipoinjection" and "adipose graft". Under eligibility criteria, two reviewers conducted an examination of each potential study.

Result: Eleven studies with a total of 849 patients were included in the systematic review and all patients received at least one fat injection. In nine studies that evaluated patient satisfaction, a total of 820 patients exhibited an high satisfaction ranging from 63 to 100% (approximately 81.2%). Complications associated with fat injection are uncommon, with edema and bruising being the most frequently reported. Three studies measured fat retention, which were < 50% (at 6 months after injection), 44.54% (range 21-74%) (at 3 months after injection) and 50.5% ± 7.0% (at 6 months after injection). A minimum of 18.61% (158) of the 849 patients enrolled underwent one or more injections. At 1-year follow-up, the reinjection rate is at least 19.27%.

Conclusion: Autologous fat injection is safe and effective for rhinoplasty. The resorbability of fat requires additional injections in certain noses where deformities are evident.

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