Abstract: Autologous Fat Grafting's Role in Primary Rhinoplasty (Plastic Surgery The Meeting (September 28

Sunday, September 30, 2018: 2:30 PM

Kyle Gabrick, MD , Yale Medical School, New Haven, CT

Cyril Gary, MD , Plastic Surgery, Yale University, New Haven, CT

Ean Saberski, MD , Plastic Surgery, Yale University, New Haven, CT

Fouad Chouairi, BA , Plastic Surgery, Yale University, New Haven, CT

Marc E Walker, MD, MBA , Plastic Surgery, Yale University, Branford, CT, United States

Rajendra Sawh-Martinez, MD, MHS , Plastic Surgery, Yale University, New Haven, CT

Derek M Steinbacher, MD, DMD , Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT

Background:

Autologous fat is a safe and effective soft tissue filler. Reports of the efficacy of fat grafting to enhance rhinoplasty in the literature are scarce. This study is a retrospective study investigating the effect autologous fat grafting on edema and ecchymoses as well as Face-Q scores following rhinoplasty.

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. Patients were asked to complete the satisfaction with face, nose, and nostrils in addition to the social and psychological function modles of the Face-Q.

Results:

One hundred patients underwent primary rhinoplasty with the senior author from 2013-2017. 40 were identified which did not have fat grafting. Age, gender, surgical approach, and osteotomy distribution was similar between the groups. In the 7-10 day time interval the fat grafted group showed 1.15cc greater edema, (p=0.65) and 3.67cm²fewer ecchymoses(p=0.05). In the 4-6 week interval, the fat grafted group showed a lower amount of edema 5.5cc vs 6.27 (p=0.64) and 0.5cm²fewer ecchymoses (p=0.42). Overall patients reported a high degree of satisfaction with appearance of the nose (75.9 +/- 5.1), the nostrils (82.3 +/- 5.2), and of the face overall (75.2 +/- 5.0), and also reported a high degree of both psychological function (82.0 +/- 5.0) and social function (79.4 +/- 5.2) per the FACE-Q.

Conclusion:

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. Additionally, fat grafting in rhinoplasty is associated with a high degree of patient satisfaction, psychological, and social outcomes.

35446 Autologous Fat Grafting's Role in Primary Rhinoplasty