Background: Rhinoplasty in patients with thin nasal skin presents distinct surgical challenges due to the skin’s tendency to contract and reveal underlying structural irregularities. In these cases, meticulous cartilage sculpting and strategic use of camouflage materials are critical for achieving satisfactory outcomes. Objective: To review the rationale, indications, and efficacy of using Platelet-Rich Fibrin (PRF), alone or in combination with cartilage and other soft-tissue grafts, to enhance camouflage and improve postoperative results in thin-skinned rhinoplasty patients. Methods: A comprehensive evaluation of clinical protocols and evidence-based practices was conducted, including the use of PRF and injectable PRF (iPRF), diced cartilage, fascia, and fat grafting. Emphasis was placed on technical nuances, such as dissection planes, graft selection, and PRF preparation protocols. The approach is grounded in current literature and clinical experience, with references to prospective studies demonstrating superior aesthetic outcomes with PRF based techniques. Results: PRF demonstrated multiple benefits in thin-skinned rhinoplasty, including reduction of edema, increased graft viability, and improved dorsal camouflage. Studies show significantly better patient satisfaction scores with the use of PRF combined with shaved cartilage, compared to traditional diced cartilage grafts alone. Additionally, adjunctive use of fat, fascia, and perichondrium further enhanced contour regularity and volume restoration in revision and primary cases. Conclusion: Platelet-rich fibrin represents a valuable adjunct in rhinoplasty for patients with thin skin, contributing to better healing, decreased complication rates, and improved aesthetic outcomes. When integrated with cartilage grafts and soft tissue camouflaging techniques, PRF provides a versatile and biologically active solution to one of rhinoplasty’s most demanding clinical scenarios.

Marina Serrato Coelho Fagundes is a highly qualified otorhinolaryngologist and facial surgeon with a comprehensive background in medicine and surgery. She graduated in Medicine from the Federal University of Paraná (UFPR) and completed a Medical Residency in Otorhinolaryngology and Cervicofacial Surgery at the Hospital de Clínicas of the Federal University of Paraná (HCUFPR). To further refine his skills, she pursued a Fellowship in Facial Surgery at the Paranaense Institute of Otorhinolaryngology (IPO). He also holds a Master's Degree in Surgery from UFPR, complemented by a postgraduate degree in Cosmiatry, reflecting his dedication to both clinical excellence and aesthetic practices. Also, she is a Full Member of the Brazilian Society of Otorhinolaryngology (SBORL) and the Brazilian Academy of Facial Plastic Surgery, demonstrating his active engagement in the professional community. Currently, she serves as a Preceptor of the Fellowship service in Facial Surgery at the Hospital Instituto Paranaense de Otorrinolaringologia (IPO), where she is committed to training the next generation of surgeons.