Prevalence of complications associated with polymer-based alloplastic materials in nasal dorsal augmentation: a systematic review and meta-analysis

Abstract

Background Various techniques with different grafts and implants have been proposed to establish a smooth and symmetric nasal dorsum with adequate function. Broadly, two categories of materials have been used in this regard: alloplastic implant materials and autograft materials. The aim of these meta-analyses is to explore the incidence of complications after dorsum augmentation surgery using alloplastic materials. Materials and methods After duplication removal 491 papers remained that title and abstract were assessed for eligibility. Regarding the study type, 27 observational studies were included, 21 retrospective and 6 prospective case series. A total of 3803 cases were enrolled in this systematic review and meta-analysis. Result Twenty-seven articles reported on complications and outcomes of dorsal augmentation rhinoplasty with synthetic materials. In a random-effects model, the weighted mean percentage was 2.75% (95% CI 1.61 to 4.17%). the weighted mean percentage were 1.91% (95% CI 0.77 to 3.54%), 0.72% (95% CI 0.316 to 1.31%), and 0.78% (95% CI 0.43 to 1.24%) respectively. Conclusion The widely used alloplasts were expanded polytetrafluoroethylene (ePTFE), high-density polyethylene, and silicone. The total rates for complications, infection, deviation, irregularity, hematoma, extrusion, and overcorrection were 2.75%, 1.91%, 0.72%, 0.70%, 0.78%, and 0.49%, respectively. The revision rate, based on the random effects model, was 6.40% with 95%CI (3.84 to 9.57). Trial registration This meta-analysis was registered at the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42020209644).

A Case With Herpes Zoster Ophthalmicus Mimicking Delayed Complication of Rhinoplasty

“…HZO is uncommon at rhinoplasty clinics, and on the other side, alloplastic graft-related infection is more common relatively. The mean percentage of infection after dorsum augmentation with alloplastic material was studied as 2.75% (95% CI, 1.61% to 4.17%) in the meta-analysis study [8]. In case of any sign of infection at the nasal tip area along with rhinoplasty history and no response to empirical antibiotic treatment, clinicians should perform surgical exploration to rule out any graft-related complication.…”

The current techniques in dorsal augmentation rhinoplasty: a comprehensive review

“…If candidates are considering DA rhinoplasty, they should consult with an experienced plastic surgeon or otolaryngologist. An evaluation of the nasal anatomy, a discussion of the individual's aesthetic goals, and consideration of their overall health are all required before the procedure can be performed [ 1 , 4 , 5 , 15 , 23 , 24 ]. There are several reasons why augmentation of the nose may be necessary: dorsal hump or nasal bump: a dorsal hump or nasal bump on the nasal bridge is one of the primary indications for augmentation of the nose.…”

“…Even though a dorsal hump does not cause functional problems for some people, they may find it bothersome. It can shape the nose to fit aesthetic preferences by having DA rhinoplasty [ 5 , 6 , 8 , 23 , 30 – 34 ].…”

Chitosan-Based Membranes for Skin Wound Repair in a Dorsal Fold Chamber Rat Model

“…Available options are limited, frequently entail donor site morbidity (as in the case of autologous skin grafts or flaps) and are often costly (in the case of alloplastic reconstructive options) [4][5][6]. There is a wide range of alloplastic materials available both for research and clinical purposes, including multiple polymers and polymer composites (such as silicone, polylactic compounds, polyurethane, polycaprolactone, polytetrafluoroethylene, and high-density polyethylene), as well as naturally occurring materials, namely cellulose and silk proteins [7,8]. Despite these options, in the clinical setting, the implantation of devices composed of these materials has been associated with several complications, such as infection, extrusion, displacement, local irregularity, and hematoma formation [8].…”

“…There is a wide range of alloplastic materials available both for research and clinical purposes, including multiple polymers and polymer composites (such as silicone, polylactic compounds, polyurethane, polycaprolactone, polytetrafluoroethylene, and high-density polyethylene), as well as naturally occurring materials, namely cellulose and silk proteins [7,8]. Despite these options, in the clinical setting, the implantation of devices composed of these materials has been associated with several complications, such as infection, extrusion, displacement, local irregularity, and hematoma formation [8]. These complications ultimately lead to the removal of the medical device in up to 28% of cases [9].…”