Failure of Synthetic Implants: Strategies and Management

Abstract

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.

A Systematic Review of Technique, Satisfaction, and Complications of Acellular Dermal Matrix in Rhinoplasty

“…First, after rhinoplasty, they are in a state of panic about potential complications and simply want to remove the implant. Secondly, they want to address esthetic concerns, and thirdly, there are complications, such as displacement, inflammation, infection, and changes in skin quality that require attention or timely management 29 . Most complications can be easily managed with revision surgery.…”

First Identification of a Patient with Prosthesis-Related Infection Caused by an MCR-1.1-Producing ST131 Escherichia coli After Rhinoplasty

“…The postoperative infection after rhinoplasty was uncommon and uncommonly reported, but can influence the suboptimal aesthetic outcome, economic losses and health threats. 1 With the development of antibiotic resistance, it is important to monitor the microbiological and antimicrobial resistance for postoperative infection of rhinoplasty. 3,22 In our study, we investigated the microbiological and antimicrobial resistance prevalence of 8 out of 173 patients who undergone rhinoplasty and had a postoperative infection, which is consistent with a low incidence in other countries (0-5%).…”

“…The common postoperative complications include displacement, extrusion, inflammation, iatrogenic injury, scarring and infection. 1 Although the infection after rhinoplasty is uncommonly reported, some processes, like osteotomies, performed during rhinoplasty breach the periosteum or nasal mucosa, creating a potential route for the spread of infection, 2,3 which can lead to the failure of plastic surgery, even increase the risk of systemic infections. The basic treatment options include continued observation, antimicrobial therapy and removal of the implant; however, some therapies could influence the aesthetics of the patients, which increases the financial cost and bring the psychological blow.…”

“…The basic treatment options include continued observation, antimicrobial therapy and removal of the implant; however, some therapies could influence the aesthetics of the patients, which increases the financial cost and bring the psychological blow. 1,4 Staphylococcus aureus and various streptococci are the main colonization bacteria and encountered pathogens associated with postoperative infections in plastic surgery. 3 To prevent postoperative infection, the use of cefazolin as a single dose is the most recommended antimicrobial for preoperative prophylaxis.…”