Problems Associated with Alloplastic Materials in Rhinoplasty

Abstract

PurposeAugmentation rhinoplasty using alloplastic materials is a relatively common procedure among Asians. Silicon, expanded polytetrafluoroethylene (Gore-tex®), and porous high density polyethylene (Medpor®) are most frequently used materials. This study was conducted to analyze revisional rhinoplasty cases with alloplastic materials, and to investigate the usage of alloplastic materials and their complications. We also reviewed complications caused by various materials used in plastic surgery while operating rhinoplasty.Materials and MethodsWe report 581 cases of complications rhinoplasty with alloplastic implants and review of the literature available to offer plastic surgeons an overview on alloplastic implant-related complications.ResultsAmong a total 581 revisional rhinoplasty cases reviewed, the alloplastic materials used were silicone implants in 376, Gore-tex® in 183, and Medpor® in 22 cases. Revision cases and complications differed according to each alloplastic implant.ConclusionOptimal alloplastic implants should be used in nasal structure by taking into account the properties of the materials for the goal of minimizing their complications and revision rates. A thorough understanding of the mechanism involved in alloplastic material interaction and wound healing is the top priority in successfully overcoming alloplastic-related complications.

Porous polyethylene implants in facial reconstruction: Outcome and complications

“…Furthermore, surgical removal of porous polyethylene can be extremely complicated compared to that of other alloplastic materials. This material adheres very sturdily to mucosa and perichondrium, indicating a thriving surrounding tissue and vascular ingrowth (Kim et al, 2014). From a purely clinical point of view, porous polyethylene implants have shown a high degree of stability and consistency.…”

Silicone-Polytetrafluoroethylene Composite Implants for Asian Rhinoplasty

“…30,31 Although there is no fixed price, reoperation cost may approach $8000 (USD) at the second author's center in Seoul, where national insurance does not cover cosmetic surgery. The potential for PTFE ingrowth to reduce malposition-the most common cause for revision rhinoplasty-and therefore cost, is an important consideration.…”

Management of complications of Medpor® implants in rhinoplasty

“…[3] and extrusion rates, ranging from 3.1% [4] to as high as 21% [5] and often require removal, which can be extremely difficult because of tissue incorporation. [5,6] Explantation surgery is treacherous as there is a high incidence of button holing, thinning, and irregularity of overlying skin and damage to surrounding structures.…”

“…[5,6] Explantation surgery is treacherous as there is a high incidence of button holing, thinning, and irregularity of overlying skin and damage to surrounding structures.…”