October
2008
Coleman Structural Fat Grafting to the Nose6
Injection of fat grafts into the nose provides surgeons with new tools to compliment their nasal surgery. Fat grafted to the nose by the Coleman method is surprisingly well integrated, assuming the structural a quality of the part of the nose into which it is placed.
Shape
Rhinoplasty surgeries often leave a nose with an “open roof.” The cartilage and bony parts of the nose have been separated so that it looks like a long trough through which the septum can be felt or even seen through the thin skin on the nose in this condition. In addition, the cartilage or bone can become deformed in many ways after rhinoplasties. The skin of the nose in some patients is so thin that irregularities can be amazingly visible, so that many structures are painfully visible through the skin after nasal surgery.
This woman had four nose procedures on both coasts and silicone injections to the nose. Follow-up at one year from one procedure (right) reveals a remarkably more normal appearing nose. The upper nose flows more naturally into the lower nose, with a more distinct central light reflex and many less irregularities. Placement into the nostril rim flattened the notching and appears to have pushed the nasal tip over to the middle from the right.
Coverage
Placing a thin layer of fat under the skin provides support for the skin and can disguise visible irregularities of the cartilage and bone. Concentrating the fat grafts into specific areas can improve the light reflex down the middle of the nose or subtly change the proportion of one part of the nose to another part.
This patient presented after at least 12 previous nasal procedures, including GorTex placement and removal, numerous cartilage grafts from her ears and one from her chest. The markings demonstrate the areas of placement. One year after one procedure, you can see softening of the irregular cartilages along with an apparent thickening of the skin over the entire nose. The area between the eyebrows is slightly fuller with a lessening of the frown wrinkles.
© Coleman 2008
hi Dr Colemen
this is the only page i found on the internet talkinf about using fat injections on the nose !
why it’s not common ?
is it safe to use fat injections on the nose to make it wider ?
for how long it stays ?
and does it stay right where it injected ?or does it move ?
thank u so much .. this page helped me a lot
Fat grafting to the nose, like everywhere else grafted fat has been used has been slow to be adopted by many surgeons. First of all, fat grafts are easy to kill when they are transferred. A surgeon needs to know how to successfully and consistently graft fat so that it lives. Then they have to learn how to use it to make three dimensional changes in the nose. Finally, they need respect the limitations of nasal procedures. I wrote an entire chapter on this subject in my latest book, just published by QMP.
Fat grafts can be used to widen or give the illusion of narrowing or straightening the nose (perhaps its most helpful use).
The grafted fat appears to stabilize between four and six months, after that there is minimal decrease in the volume, but many patients continue for years to see improvement in the quality of the skin overlying the graft.
It is possible to move grafted fat in the first few days; but, after that initial period, it stabilizes so that it would be very difficult to move.
Please call my office 212 571 5200 and speak with my office staff for further information.
Please provide some advise, I too find that there is no research available on the subject of using fat transfers to augment the nose. I am looking at having a depression in my supratip area filled in with fat transfers (centrafused). I dont tink this wil be a problem, what I am more interested in knowing Dr. Coleman, is can fat transfers be used to raise a nasal/nose tip, in my case it is only ever so slightly that I am hoping to raise. Any feedback on this would hugley appreciated, thank you, Darren in Canada
Darren,
Structural fat grafts can be used to alter the shape of the nose, depending on your situation. Please call my office at +1 212 571 5200 and speak to Renee in my office. She can arrange for a consultation either by email or phone from canada or here in New York.
Syd Coleman
Dear doctor!
I had several revision rhinoplasty.
I have rib cartilage in my tip and it’s hard when you touch it.
I would like to have bigger nose tip- for 1mm. Is it possible for fat to survive in my tip even there is rib cartilage and it’s quite hard?
Thank you
Lara,
Fat grafting is one of the best ways to soften and enlarge a tip such as you describe.
Syd Coleman