Injection rhinoplasty A Comparison between Autologus Fat Injection and Restylane Injection (Hyaluronic Acid)

Abstract

Surgical rhinoplasty remains the most definitive way to improve the appearance of a patient’s nose. However, patients increasingly seek out therapies that are less invasive, have little to no down time, cost less and have reduced risk, even if the results are not permanent. Over the last decade, various synthetic injectable fillers have become available that now make it feasible to correct nasal deformities non-surgically. The aim of this thesis is to evaluate the recent trend in the choice of injection techniques in Non-Surgical Rhinoplasty via comparison of Autologous Fat Injection and HA Injection, short term follow up of the patients after one week and one month consequently with photography in both visits, evaluating the patient satisfaction (subjective) and our assessment (objective) in both visits. This study was conducted on two groups: one comprising 15 patients in whom HA was injected to nose in the period between December 2014 to January 2016, and another group of 15 patients too, in whom Autologous FAT was injected to nose in the same period mentioned above. Our experience with 30 patients fulfilled our selection criteria submitted to a non-surgical ‘office based’ alternative to improve contour: tip projection ⁄ rotation, columellar retraction, columellar deviation and dorsal irregularities, side wall depression, camouflaging nasal deviation in non-wide dorsum, alar retraction, camouflaging step deformity resulted from high not proper osteotomy in previous rhinoplasty. Most of our patients in both groups were satisfied with the results, and objectively the results were better than our expectations in both groups. The group injected with HA criticizes the temporary effect of the filler and hope if it will stay for longer time in their noses despite this point they express their overall satisfaction and happiness with the result, we discuss with them the possibility of permanent injection of fat after the disappearance or decrement of the filling effect of filler from their noses: 8 of them accept and love the notion, 3 refuse it and 4 of them said they want to see the longevity of the filler on their noses and decide what to do then, whether to refill with filler or fat. The second (Fat) group complains of mild pain in the fat harvesting site from the lateral aspect of the thigh, despite that they express their happiness of the permanent result of fat injection in comparison to temporary effect of HA. Examination of our patients injected with fat one month later shows some decrement of the amount injected in comparison to immediate post-injection pictures which forced us to re-inject another volume of fat, and this point lead us to think about injecting a little bit more than the wanted volume from the first session (we start to slightly over-inject fat after doing 8 patients) to obviate the need of another session of harvesting and injection of fat.