Q: Dr. Eppley, i am interested in nano fat grafting. I have heard that fat is beneficial to scar contracture but also I am aware that fat won’t survive in a scar bed and I could wind up with lumps. That is why I thought that the nanofat probably won’t do any harm and may even help. The side of my nose that has a depression or drop off angle is the area with the scar tissue build up. The tissue is parchment thin there. I would like to fill this area with an autologous material. I had surgery 3 years ago to revise a rib graft done nearly 6 years ago which left me with unatural harsh drop offs on either side of my bridge. I already had restylane done last year and it lumped up on me and caused too much pressure in my nose. I have also been considering trying belotero filler, Would you have any suggestions?
A: While I think nano fat grafting would not hurt, I don’t think it will produce any positive benefits in terms of filling in skin depressions or rib graft step off areas. This all would be better served to be filled with alloderm (allogeneic) dermal grafts.
There is a difference between scar tissue build-up (contracture) and trying to make the skin thicker or fill in contour depression areas. If the rib graft not has sharp edges or visible stepoffs,, adding a layer of alloderm or been temporalis fascia would be the more assured way of improving the soft tissue cover.
Dr. Barry Eppley