Fat Grafting for Rhinoplasty

The Problem

Despite more than 100 years of progress, there is still no consensus about the best way to augment the nasal dorsum. Local deformities of the nasal dorsum range from subtle, such as a slight convexity, and more severe, as those seen in saddle noses affected by vasculitis.

The Background

In the dorsum, multiple approaches and techniques are used to correct deformities. Frequently, defects of the dorsum may be ascribed to partial resorption of grafts or irregular osteotomy. Options for correcting these defects, when extensive, can include a monobloc onlay graft, dorsally extended spreader grafts, camouflage grafts, and diced cartilage in fascia, along with its many variants. Septal, conchal, and costal cartilage can be used, with costal cartilage typically used for major deformities requiring strong structural support. Structural approaches in rhinoplasty remain dominant, and there has been a proliferation of graft use in both primary and secondary operations. In recent years, the use of autologous fat grafting has gained popularity in the correction of dorsal deformities both in aesthetic and reconstructive surgery.

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