Rhinoplasty is well known to be one, if not the most, challenging of all aesthetic plastic surgery operations. Surveys of plastic surgeons verify this historic belief and it is as true today as it was decades ago. It is one of the few plastic surgery procedures where entire educational courses and textbooks are devoted to the subject. Besides the issue that it is an operation whose results are open to heavy scrutiny given its central location on the face, it has to be done through somewhat limited access and often requires grafting materials to exhibit its best effects. How to put a nose together that will end up aesthetically pleasing has as much artistic component to it as it does hard science. But the vexing part of rhinoplasty is the unpredictable healing process which may make what looks great on the operative table different months to years later.
One of the newest aesthetic plastic surgery procedures, that is equally challenging to rhinoplasty, is that of fat grafting. Fat grafting is a very versatile procedure that can solve a large number of cosmetic and reconstructive problems, but its results are highly unpredictable. Like rhinoplasty, what looks good on the operative table may not always turn out so later. While the techniques of harvest and injection for fat grafting are far simpler than that of rhinoplasty, its unpredictability comes from a completely different healing reason. We do not yet understand the biology of fat and stem cells and how they can best respond to being transplanted. This has led to fat grafting becoming a procedure that now has its own educational courses and textbooks. Searching for improved and sustained results, much like rhinoplasty, is sure to have fat grafting becoming a focus of continual plastic surgery educational and research efforts for decades to come. Fat grafting today has become the rhinoplasty of years past…challenging, unpredictable and open to a wide number of surgical techniques and nuances.
Dr. Barry Eppley
Indianapolis, Indiana