Dorsal Augmentation using Alloplastic Implants

Na, Hyung Gyun; Jang, Yong Ju

doi:10.1055/s-0036-1598015

Cited by 27 publications

(32 citation statements)

References 8 publications

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“…A high nasal starting point gives a strong facial impression seldom preferred by female Asians. 2 Especially for people who have poorly developed and flat foreheads, excessive radix augmentation can create an unnatural-looking nose with no clear distinction between the nose and forehead. The nasofrontal angle should have a gentle curvature.…”

Section: Aesthetic Dissatisfaction Caused By a Synthetic Dorsal Implantmentioning

confidence: 99%

“…The nasofrontal angle should have a gentle curvature. 2 However, for patients with a sunken radix, showing relatively sharp nasofrontal angles, if beveling of the upper end of the implant was not performed well, the cephalic margin of the implant can be conspicuous when seen from the front. This phenomenon is common among patients with a prominent forehead.…”

Section: Aesthetic Dissatisfaction Caused By a Synthetic Dorsal Implantmentioning

confidence: 99%

“…1 The majority of patients who undergo this kind of surgery like the aesthetic improvement; however, complications related to the use of synthetic implants occur not infrequently. 2 Thus, surgeons should be well aware of how to recognize the probable problems and how to manage them. Patients who had prior rhinoplasty with a synthetic implant usually visit the surgeon for three reasons.…”

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Failure of Synthetic Implants: Strategies and Management

2018

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Dorsal augmentation with synthetic implants is the most commonly performed rhinoplasty procedure, especially in the East-Asian region. However, as in all other surgical procedures, complications are inevitable. Complications that need to be managed surgically include displacement, deviation, suboptimal aesthetic outcome, extrusion, inflammation, infection, and changes in skin quality. Most complications can be easily managed with revision surgery. After the removal of the synthetic implant from the nasal dorsum, different dorsal implant materials such as dermofat, alloderm, or fascia-wrapped diced cartilage, conchal cartilage with perichondrial attachment, and costal cartilage are preferred. An irreversible change in the skin/soft tissue envelope poses a challenge that usually requires reconstructive surgery with a local flap. Therefore, early detection and prompt management of the complication are essential for minimizing the severity of the deformity and the complexity of the surgical procedures.

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Section: Aesthetic Dissatisfaction Caused By a Synthetic Dorsal Implantmentioning

confidence: 99%

Section: Aesthetic Dissatisfaction Caused By a Synthetic Dorsal Implantmentioning

confidence: 99%

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confidence: 99%

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Failure of Synthetic Implants: Strategies and Management

2018

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“…This is a complex procedure that requires experience and immense effort. 16 Complications such as infection, inflammation, displacement, and extrusion are other concerns when using alloplastic materials.…”

Section: Dorsal Augmentation After Septal Reconstructionmentioning

confidence: 99%

Refinements in Saddle Nose Reconstruction

Chen

Jang

2018

Facial plast Surg

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Saddle nose correction remains a challenging procedure for rhinoplasty surgeons due to both aesthetic and functional issues. The most common causes of saddle nose are nasal trauma and prior septal surgery, and a defective relationship between the caudal septum and the anterior septal spine is the principal postoperative pathology. The authors propose their own classification system for saddle nose with one new category and several approaches to deal with this condition in accordance with the level of severity. They strongly advocate major septal reconstruction for most cases of saddle nose, either by placing extended spreader grafts, caudal extension grafts, or a new extracorporeally made L strut. For extreme cases, integrated dorsal implant with columellar strut can successfully bypass the saddled nasal dorsum without dissecting the septal mucoperichondrial pocket and achieve adequate dorsal height. Further dorsal augmentation can be achieved by applying side/gap grafts or dorsal onlay grafts in different forms. In cases with retracted columella, a premaxillary plumping graft is another useful technique. Finally, in autoimmune-related saddling patients, the evidence indicates that their aesthetic problems can be managed safely with surgery as long as the disease is well under control.

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“…28 Extrusion rates for silicone are as high as 4%. 29 Limiting firmer implants to thicker-skinned patients and placing them under the periosteum may decrease the risk of extrusion.…”

Section: Extrusionmentioning

confidence: 99%

Dorsal Failures: From Saddle Deformity to Pollybeak

Hamilton

2018

Facial plast Surg

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The nasal dorsum is an important component of a rhinoplasty and may be the primary motivation for seeking surgery. The nasal dorsum is a complex three-dimensional shape that is shrouded by local anesthetic and edema during surgery. This makes an accurate assessment of the surgical changes challenging. Complications related to dorsal modification include imbalances from over- or underresection of the structures of the nasal dorsum, inadequate or overaugmentation, an open-roof deformity, pollybeak, saddle nose, inverted-V, warped cartilage, visible grafts, contour problems, graft malposition, and extrusion. This review will discuss the common problems that can occur with dorsal modification during rhinoplasty.

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Dorsal Augmentation using Alloplastic Implants

Cited by 27 publications

References 8 publications

Failure of Synthetic Implants: Strategies and Management

Failure of Synthetic Implants: Strategies and Management

Refinements in Saddle Nose Reconstruction

Dorsal Failures: From Saddle Deformity to Pollybeak

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