Use of the Autologous Membrane in Structured Rhinoplasty: An Alternative to Camouflaging and Filling.

2020 
Rhinoplasty is one of the most challenging procedures in plastic surgery because the surgical modifications should attend to patient expectations and to the need for functional correction allied to aesthetics. Composed of leukocytes and platelet-rich fibrin, an autologous membrane has great potential for tissue repair. The purpose of this study was to assess the use of this membrane (associated or not associated with diced cartilage) as an alternative to techniques such as the camouflage and filling; correction of irregularities of the dorsum, nose tip, soft triangle, and K zone; filling in of dead space; skin camouflage; and an improvement in the healing process in primary or secondary rhinoplasties. Methods The membranes were obtained by centrifuging patients' peripheral blood before the rhinoplasty. At the time of use, the membrane was removed from the tube, separated from the clot, and used in the camouflage and filling process in patients operated on due to various indications: 19 associated with diced cartilage, and 4 sole. The authors present the clinical and photographic impressions of the immediate and late postoperative period, as well as the patients' opinions using a specific questionnaire. Results No patient had immediate or late postoperative complications. The use of leukocyte- and platelet-rich fibrin (L-PRF) was sufficient to carry out the camouflage and filling in all patients, and the patient declared satisfaction. Conclusions This membrane was shown to be an excellent surgical alternative to the camouflage and filling in rhinoplasty. In addition, it is rich in factors that can improve and accelerate regeneration of tissues.
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