Clinical Observation And Basic Research Of Rhinoplasty With Dermal Adipose Tissue Repair

Objective:To study the safety and effectiveness of applying dermal adipose tissue for secondary rhinoplasty and to investigate the characteristics of absorption rate over time after autologous transplantation of dermal adipose tissue through animal experiments.Methods:This study was divided into two major parts.In the first part,patients with complications after rhinoplasty were treated clinically and autologous dermal adipose tissue was used as the secondary rhinoplasty filler to observe its clinical effect.In the second part,20 New Zealand rabbits were selected as experimental subjects for autologous dermal adipose tissue nasal dorsal transplantation,and the grafts were taken at 2,4,8 and 12 weeks after transplantation,and the quality of the grafts was measured,and HE staining,Sirius red staining and CD34 immunohistochemical staining were performed to observe the histological changes.Results:In the clinical study,18 patients who underwent secondary rhinoplasty and repair were followed up for 3 months after surgery.It was observed that the appearance of the nose was significantly improved compared with that before surgery,and no skew or slosh of fillers was observed.The patients with high nasal back,visible prosthesis and clear nose tip before surgery were well corrected.The incision in the nasal and donor area healed well without infection or necrosis.All patients were satisfied with the results of the operation,and the postoperative nasal appearance score was significantly improved compared with that before surgery,the difference was significant.In animal experiments,it was observed that the retained quality and quality retention rate of grafts decreased gradually at 4 and 8 weeks after transplantation(P<0.05)and stabilized at 8 weeks after transplantation with a retention rate of 73.45%,which was not statistically significant compared with 12 weeks(71.88%)after transplantation(P>0.05).With the progress of time,the shape of fat cells in the adipose layer was gradually irregular,collagen fibers were gradually increased,and new blood vessels were generated,while the changes in the dermis were not obvious.Conclusion:Autologous dermal adipose tissue can be used as a filler for secondary rhinoplasty repair,especially for patients with problems such as light transmission and appearance of prosthesis due to thin skin after initial rhinoplasty,with reliable effect.The absorptivity of dermal adipose tissue autologous transplantation was low and stabilized 8 weeks after transplantation.The retention rate was higher than 70%.The histological changes were mainly in the adipose layer.