Journal time! This month’s Aesthetic Surgery Journal was chock full of good info. I usually skip the rhinoplasty and nose articles, since I do not do rhinoplasties anymore, but this one caught my eye because I do FAT GRAFTING all the time, all over the face, and I love to fat graft at the base of the nose. Turns out, I unwittingly am helping treat exactly what this article was about.
“The Influence of Paranasal Augmentation of the Measurement of the Nose for the Treatment of Midfacial Concavity.” That is a mouthful. What they are talking about is that the midface is frequently concave, so you have DEEP nasolabial folds (think about the parenthesis around your mouth). Turns out, that is associated with not looking as pretty.
So they did a study, where they increased the fill near the base of the nose. They used bone, cartilage, or an implantable material PPE. They accessed it through the mouth mucosa.
Results?
- They followed it up at a year.
- The mean thickness of the grafts was 5mm.
- Alar width and base width increased by around 5%.
- The nasolabial angle did not change significantly.
My thoughts?
This study came out of Taiwan, where they say there is general maxilla hypoplasia (less development of the upper jaw bones which support the nose) found in certain ethnic groups. They are trying to add deep structure, hence their use of more durable building blocks like rib and bone. In my practice, I love fat grafting. I would much rather use fat for the ease of harvest, the ability to layer and sculpt fat, and the ease of placing the fat. I do not know what the average change is when I place fat, and I doubt it is giving the same amount of projection. But it is improving the area with a simple, lower risk procedure. This is an area I always graft when doing fat grafting to the face. I see the tip of the nose rise and the nose looks better supported, the upper lip looks better.