Đánh giá kết quả ghép mỡ sau lấy bỏ vật liệu nhân tạo trên bệnh nhân có biến chứng sau phẫu thuật nâng mũi

Abstract

Background: Complications following alloplastic rhinoplasty, such as infection, extrusion, and capsular contracture, pose significant challenges. Implant removal often results in severe deformities like short nose, thin skin, and scar contracture. Autologous fat grafting is a promising solution for volume restoration and tissue regeneration. Objective: To evaluate the aesthetic outcomes and safety of autologous fat grafting after artificial implant removal in patients with complications. Subject and method: A case series study was conducted on 59 patients with complications after alloplastic rhinoplasty treated at Cho Ray Hospital. The procedure involved implant removal, debridement, and autologous fat grafting (macrofat/microfat). Outcomes were assessed using clinical photography, ultrasound measurement of skin thickness, and the Rhinoplasty Outcome Evaluation (ROE) scale preoperatively and at 1, 3, and 6 months postoperatively. Result: The mean age was 32.5 ± 8.4 years. Mean follow-up was 6 months. Infection was controlled in 100% of cases with no recurrence related to the fat graft. Dorsal skin thickness increased from a mean of 1.8mm to 3.5mm after 6 months (p<0.05). ROE scores improved from 28.5 preoperatively to 72.4 at 6 months. The satisfaction rate was 89.8%. The main complication was fat resorption requiring touch-up (10.2%). Conclusion: Autologous fat grafting after implant removal is a safe and effective method for maintaining nasal contour, improving skin quality, and preventing contracture, especially in infected fields.