title: Correction of Severely Contracted Nose.
abstract: BACKGROUND
  Severely contracted nose is manifested with a tight and hardened nasal envelope. Expansion of the contracted skin is an important first step in correcting these revision cases. The underlying weak lower lateral cartilage makes the tip projection structurally difficult to achieve and maintain without rigid supporting cartilage grafting.
  
  
  METHODS
  A total 59 of patients were treated with isolated adipose-derived stromal cells before revision surgery to soften the nasal envelope. Adipose tissues were digested at 37°C with sterile 0.075% collagenase type 2. The average isolated adipose-derived stromal cell count of each serial injection was 5 × 10 cells (total injection volume, 0.5 ml; 1 × 10 cells/ml). Intraoperatively, the lower lateral cartilage was released from surrounding scar tissue to allow for advancement. Rib cartilage and other autologous grafts were used in reconstruction of the internal framework.
  
  
  RESULTS
  The follow-up period ranged from January of 2009 to April of 2014. The mean follow-up period was 10 months. Fifty-one of 59 patients were satisfied with their results. Eight patients underwent revision surgery for the following: infection (two patients), deviation (one patient), warping (two patients), and cosmetic dissatisfaction (three patients). There were two cases of additional warping, but the patients refused revision surgery. Nine patients required additional adipose-derived stromal cell injections at the tip.
  
  
  CONCLUSIONS
  The combination of isolated fat grafting to soften the nasal skin envelope and rigid tip support results in correction of silicone-induced contracted nose. There were no incidences of recurrent nasal contraction or ischemic injury.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Oh
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: Je Won
authors.initials: JW
authors.lastname: Seo
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: Se Joon
authors.initials: SJ
authors.lastname: Oh
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: Ick Tae
authors.initials: IT
authors.lastname: Oum
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: Gukjin
authors.initials: G
authors.lastname: Kim
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: Jun
authors.initials: J
authors.lastname: Kim
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: Sa Yong
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Shin
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: DaEun
authors.initials: D
authors.lastname: Park
authors.affiliation: Seoul, Republic of Korea; and Los Angeles, Calif.|From Oh and Young Plastic Surgery; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
authors.forename: Kenneth K
authors.initials: KK
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D003286:Contracture / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055171:Nasal Cartilages / Q000601:surgery; D011300:Preoperative Care; D012225:Rhinoplasty / Q000379:methods*; D055815:Young Adult