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Kyle Gabrick, Marc Walker, Andrew Timberlake, Fouad Chouairi, Ean Saberski, Derek Steinbacher, The Effect of Autologous Fat Grafting on Edema and Ecchymoses in Primary Open Rhinoplasty, Aesthetic Surgery Journal, Volume 40, Issue 4, April 2020, Pages 359–366, https://doi.org/10.1093/asj/sjz075
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Abstract
Autologous fat is a safe and effective soft tissue filler. Recent evidence also suggests improved wound healing and immune modulation with fat grafting.
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.
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.
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.
Autologous fat grafting is a useful adjunct to rhinoplasty and is associated with significantly fewer ecchymoses in the acute postoperative period.