A systematic review of complications associated with nasal augmentation implants: expanded polytetrafluoroethylene (Gore-Tex) versus silicone

Abstract

Background: Augmentation rhinoplasty has been one of the most common cosmetic procedures in Asian population. Silicone is the most widely used nasal augmentation material in Asia. However, in the past few decades, expanded polytetrafluoroethylene (ePTFE, Gore-tex ® ) has become more popular as an alternative.Objective: In this study, complications associated with each implant aresystematically reviewed. Methods: Heuristic searches of MEDLINE, PubMed, and the Cochrane Library were performed using the keywords "ePTFE", "Goretex", "silicone", and "rhinoplasty" to identify manuscripts for inclusion. The reference lists of these articles were systematically reviewed to further identify relevant articles. Only studies with detailed complication reports (i.e., infection, malposition) were considered. Random effects meta-analysis was performed to calculate the significance of differences in complication rates between silicone and ePTFE.Results: Eighteen studies encompassing a total of 7,759 patients were analyzed, 12 with ePTFE and 6 with silicone. Among studies in which sex was reported, 88.8% of the patients were female. 88.4% of cases in the silicone group were primary, as compared to 78% in the ePTFE group. Overall complications were 5.3% for the ePTFE group and 9.2% for silicone (p<0.05). Infection rate was similar between the two groups, 1.4% for ePTFE versus 1.9% for silicone group (p>0.05). Exposure rate was also similar, 0.7% for silicone and 1.2% for ePTFE (p>0.05). Malposition rates were significantly lower in ePTFE group compared to those receiving silicone implants (2.4% versus 6.8%, p<0.05). Conclusion:Although the gold standard graft material for rhinoplasty remains autologous tissue, implant based rhinoplasty is far more common in Asian populations. Both silicone and ePTFE have acceptable risk profiles when used in selective patients for dorsal augmentation. However, given the additional risks of capsular contracture and implant malposition associated with silicone implants, ePTFE should be considered as a first-line option for implant-based nasal augmentation.

Design and Application of a Novel Silicone Nasal Implant

“… 8 , 17 Hoang et al reported a 9.2% overall complication rate related to silicone nasal implants. 18 Complications after rhinoplasty are mainly related to the natural effect of gravity, tissue tension around the nasal implant, and external forces. If an implant can solve such postoperative complications, it is considered a very good rhinoplasty material.…”