Rhinoplasty is the most common procedure seen in the teenage population. Many of these patients have facial imbalance both recognized and unrecognized by the individual and family. Most often it involves chin or midface deficiency. When the discussion involves the possibility of additional surgery, such as an alloplastic chin implant or a surgical osteotomy, the conversation halts because the patient and family seek a simpler solution.
Autologous fat transfer is a useful adjunct to achieve facial balance in chin and cheek in the teen population. More recently, we have been using this technique to correct facial disharmony in rhinoplasty patients.
Fat grafting was performed at the time of rhinoplasty in 22 patients (age, 15–19 years). Presurgical planning involved cephalometric and computer-enhanced photographic analysis of the face. Midface retrusion and underprojected mentum were treated. Deficient sites were treated with small aliquots of fat, which were injected into the supraperiosteal plane. The average amounts of fat grafting injected per region were 2 to 3 mL for the malar region and 8 to 10 mL for the chin and geniomandibular borders.
Twenty-two patients underwent augmentation of soft tissue and skeletal deficiencies. Analysis of postoperative results showed excellent outcomes with enhancement of facial profile and proportions. The mean follow-up was 3 years. The majority of patients reported high degree of satisfaction. No complications were observed.
The combination of rhinoplasty and autologous fat grafting offers very satisfactory esthetic outcomes and improvement of facial balance with minimal added time, cost, and risk.
From the *Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
†Long Island Plastic Surgical Group, Garden City, NY.
Received June 25, 2018, and accepted for publication, after revision November 7, 2018.
Conflicts of interest and sources of funding: none declared.
Presented at the American Association of Plastic Surgeons, April 7–10, 2018, Seattle, WA; ASPS Aesthetica Super Symposium 2015, April 30–May 12, 2015, Las Vegas, NV; New York Regional Society of Plastic Surgeons Residents' Night, March 9, 2015, New York, NY; 31st Annual Meeting, Northeastern Society of Plastic Surgeons, September 12–14, 2014, Providence, RI; and the 13th American College of Surgeons/Nassau Surgical Society Annual Clinic Day Meeting, Uniondale, December 3, 2014, Long Island, NY.
Reprints: Munique Maia, MD, Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St, Lowry Suite 5A, Boston, MA 02215. E-mail: email@example.com.