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Adipose-derived stromal cell injection sufficiently softens scar tissue in contracted nose rhinoplasty

The injection of adipose-derive stromal cells into nasal scar tissue aids in the repair of silicone-induced contracted nose, according to study results published in Plastic and Reconstructive Surgery.

From September 2006 to January 2014, researchers conducted a study of patients undergoing surgery to correct a severely contracted nose. Prior to surgery, 59 patients underwent adipose-derived stromal cell injections to soften the existing scar tissue. The remaining 21 patients underwent presurgical treatment with saline injections and served as a control group.

There were nine men (11.25%) and 71 women (88.75%) with an average of 3.21 prior rhinoplasties. The patient age range was 17 to 63 years.

The adipose-derived stromal cell group received average injections of 5 × 10⁶ cells (total injection volume, 0.5 ml; 1 × 10⁷ cells/ml) in the nasal tip and any region with significant scar tissue. The average treatment duration was 28.7 days with an average of 11.5 injections (range, 7-27). The control group received an average of 14.1 saline injections over a period of 1 month into the same regions. The depth of injections for both groups was at the subcutaneous layer.

Once the nasal envelope softened adequately, all patients underwent revision rhinoplasty. As the patients did not have sufficient septal cartilage to serve as a donor site, rib cartilage grafts were harvested from the eighth and ninth rib to serve as a columellar strut graft. Average follow-up was 2.3 years (range, 1-7).

“Presurgical treatment with adipose-derived stromal cells showed improvement of nasal envelope contracture and improvement of nasal tip dimpling and contracture,” the researchers wrote. “We did not see any significant further scar contractures. However, we did see minor scar contracture that would typically be expected with any rhinoplasty procedure. At 6 months postoperatively, the outcomes remained stable and consistent.”

The use of saline injection in the control group did not show sufficient skin envelope expansion. Within the adipose-derived stromal cell group, eight patients (13.5%) underwent further revision rhinoplasty after the operation in relation to infection (two patients), deviation (one patient), warping (two patients), and cosmetic dissatisfaction (three patients). – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.