Immediate Autologous Granular Fat Grafting with Modified Techniques for Chronic Prosthetic Rhinoplasty Infection: A Single-Case Experience

Abstract: Managing chronic infection after prosthetic rhinoplasty is clinically challenging. Traditional staged treatment involves prolonged waiting periods, often leading to nasal dorsum collapse, soft tissue contracture, and increased difficulty of secondary surgeries. Immediate autologous fat grafting after infected implant removal has been reported, but technical limitations such as unstandardized debridement and aggressive fat processing remain. We report a case of a 48-year-old female patient with chronic infection one year after ePTFE prosthetic rhinoplasty, unresponsive to a 2-week course of oral amoxicillin-clavulanate potassium. A single-stage procedure was performed, including complete prosthesis and capsule removal, restricted cavity debridement, and immediate transplantation of minimally processed autologous granular fat (simple gauze filtration without washing/centrifugation) into the original cavity. During one-year follow-up, no signs of infection recurrence were observed, and the nasal dorsum contour remained stable and natural without collapse or deformity. The patient reported satisfaction with the aesthetic outcome and declined further implant-based surgery. This single-case experience suggests that single-stage debridement combined with immediate autologous granular fat grafting may be feasible for carefully selected patients with chronic, localized, low-virulence prosthetic rhinoplasty infection. The modified techniques described (restricted debridement, minimal fat processing, elastic tape fixation) warrant further investigation in larger studies. Keywords: rhinoplasty, chronic implant infection, autologous fat grafting, restricted debridement