What is dermal grafting? How it naturally raises the bridge of the nose, and the limits of absorption

Dermal grafting is a procedure in which the dermis (the deep layer of skin) with the surface layer removed from your own skin is transferred to areas that need volume. Dermofat grafting, which transfers the subcutaneous fat along with the dermis, is used to naturally raise the nasal bridge in people with thin skin[1]. However, since some of the transplanted tissue is absorbed, the final result can be difficult to predict[1].

What can dermal grafting do?

The main use is to raise the nose. Dermal grafts (transplanted tissue) are said to be usable in surgery to raise the nose[2].

Dermofat grafting is used not only to add height to the nasal bridge, but also to smooth out fine irregularities on the nasal bridge, nasal tip, and nostrils[1].

Outside the nose, it is also established as a method to address volume deficiency in the lips. A method of transferring dermofat to people who lack sufficient red lip tissue after cleft lip surgery has been reported[3].

What type of nose is it suited for?

It is most suited for people with thin nasal skin. Even in people with thin skin, it is said that natural-looking height can be achieved[1].

Dermofat grafting is made up of two layers: the dermis and subcutaneous fat[1]. By transferring not just the dermis but also the fat together, it compensates for lacking volume[1].

How much remains? What are the limits of absorption?

Some of the transplanted dermofat is absorbed. For this reason, the final result after surgery is said to be difficult to predict[1].

Within the scope of research reviewed here, no studies were found that quantified how much of your own dermis remains. It is realistic to understand that this is a procedure where you cannot say for certain "X% will remain".

What is the difference from using dermis from another person?

Overseas, there are reports of using processed dermis from donors to conceal irregularities on the nasal bridge and nasal tip[4]. This is a different material from dermal grafting using your own dermis.

In that study, 77% of 91 patients underwent revision surgery, with the aim of thickening thinned skin[4]. With an average follow-up of 3.8 years, shape problems occurred in 1%, absorption in 3%, and infection in 4%, with all infections resolved by oral medication[4].

Compared to the point that partial absorption is expected with your own dermis, you can see this is a material with different properties. Which one can be used depends on the facility and your condition.

Is there a use for treating missing skin?

Yes. There is a report of treating 7 patients with missing nasal skin using a method of transferring skin with the surface layer removed[5]. It is presented as a method to avoid creating new scars on the face[5].

This is more of a reconstructive use after injury or surgery rather than a cosmetic purpose. Even though it is "transferring dermis," the method differs depending on the purpose.

What should be confirmed in a consultation to see if it suits you?

What you want to confirm is the thickness of nasal skin, how much height you want to add, and where the dermis will be taken from. Since this procedure involves absorption, also ask how the situation would be addressed if there is insufficient volume.

This cannot be decided by photos or articles alone. Having a consultation where the nose is actually examined and the reason it is recommended over other methods is explained will make it easier to decide.