Dermal graft: where to have it done? Choose based on whether absorption rates and scarring are explained upfront

Dermal grafting is best chosen from a clinic that specifically explains how much will be absorbed and where the skin will be harvested[1][2]. Grafts with attached fat are reported to absorb 15–45%, and in studies where dermis was folded and placed in the bridge of the nose, height decreased by 38% in the first 6 months[1][3]. Suitability also varies depending on skin thickness and whether there is a history of previous surgery or infection[4].

How much absorption is expected?

Dermal grafts do not remain completely as placed. Grafts with attached fat are reported to absorb 15–45%, and the amount varies depending on dermal thickness, skin tension, and blood circulation[1].

In a study of 14 patients where dermis was folded and placed in the bridge of the nose, the height of the graft decreased by 38% in the first 6 months[3]. Despite this, changes in overall bridge volume are modest, and the tip height stabilizes slightly after declining and then remains steady from 6 months onward[3].

In a study of 56 patients where dermis was placed at the side of the nostril, absorption was 38.72% at 6 months, 49.36% at 12 months, and 49.92% at 18 months[5]. By one year it is reduced to approximately half, after which it remains essentially flat[5]. Confirm before surgery how much excess will be placed and what will be done if reduction occurs

How are the harvest site and scarring determined?

A linear scar remains at the skin harvest site[2]. Since there is a limit to how much can be harvested, the decision of where and how much to take is based on both final appearance and scarring[2].

The thickness of the dermal graft also varies depending on the harvest site. Taking from the fold of the buttocks can result in dermis that is too thick, making the nose appear round and prominent, while the groin has loose skin and is reported to allow easier, larger harvests[6]. Also discuss whether the scar site can be hidden by clothing

Is it suitable for my nose and skin?

It is most suitable for people with thin skin over the bridge of the nose or those lacking sufficient cartilage to raise the nose[4]. An advantage is that even with thin skin, height can be achieved with a natural appearance[4].

It is also used on noses that have had problems after infection or complications from synthetic materials, or after removal of paraffin injected in the past[4][6]. On the other hand, in areas that move frequently like the lips, it is considered less suitable because it lacks suppleness[2].

How does it compare with other methods?

Fat injection is another method to raise the bridge. In a study of 198 patients who received fat injection, 63.1% reported satisfaction after 1–3 injections[7].

In facial fat injection, the amount remaining at an average of 13.9 months was an average of 41.63%[8]. Comparing methods becomes easier when you consider that all methods involve reduction and plan how many surgeries will complete the result

What if infection or displacement occurs?

The limitations of dermal grafting include absorption, as well as infection, displacement of the graft, and burden on the harvest site[1]. There are also suggestions that it is relatively susceptible to infection[2]. Confirm in advance that the surgical facility can examine you if redness or swelling persists or if the shape becomes displaced

Where to have it done? A guide when undecided

During your consultation, ask the following:

Absorption: what reduction is expected and what criteria are used to determine the amount[1][5]

Harvest site: where will it be taken from and where will the scar remain[2][6]

Suitability: will skin thickness and history of surgery or infection be assessed[4]

Comparison: will other methods such as fat injection be explained side-by-side[7][8]

Follow-up care: can you be examined if infection or displacement occurs[1]

Whether dermal grafting is suitable for your nose cannot be decided from this article alone—it depends on your skin thickness, amount of cartilage, and condition of past surgery sites. At your consultation, have your nasal skin and foundation examined, and confirm both the expected absorption and scar location before deciding