The classification of complications after augmentation rhinoplasty

Shirakabe, Yukio; Shirakabe, Takehiro; Kishimoto, Takeshi

doi:10.1007/bf01570849

Cited by 35 publications

(10 citation statements)

References 2 publications

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“…[15][16][17] They are mostly due to overcorrection or high pressure of the overlying skin. 4,18 As of yet, these complications have still not been experienced with our footplate incision procedure, though the follow-up time may not have been sufficient. When simultaneous alar base augmentation is required for the correction of the retracted alar base, cartilage or an implant can be inserted into the alar base pocket through this incision, without making any additional incision necessary.…”

Section: Discussionmentioning

confidence: 71%

Advantages of Adding a Footplate Incision in Asian Rhinoplasty

Han¹,

Ko²,

Kim³

2004

Annals of Plastic Surgery

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The dimension, shape, and projection of the nasal tip are significantly determined by the position of the footplates of the medial crura. The length of the footplate segment in Asians is much longer than that in Caucasians. A surgeon may be able to use a longer footplate segment when operating on an Asian to recreate the lower vault of the nose more effectively. The purpose of this study is to introduce the advantages of addition of a footplate incision to obtain greater satisfaction in esthetic rhinoplasty for Asians. This incision is extended along the caudal border of the footplate of the medial crura onto the floor of the nasal vestibule bilaterally, in endonasal or open approach rhinoplasty. By approximating the lateral curves of the medial crural footplates, the width and the length of the columella could be narrowed and lengthened. The columella can also be advanced caudally and thus elongate the shape of the nostrils. In addition, a cartilage graft or an implant insertion for alar base augmentation could be performed through this footplate incision, eliminating the need for an additional incision. Another advantage is that, during the correction of caudal septal deviation, displaced septal cartilage can be repositioned by suturing to the periosteum or soft tissue around the anterior nasal spine without drilling into it through an intraoral incision. One hundred ten consecutive patients who underwent esthetic rhinoplasty using our footplate incision technique between August of 1999 and May of 2002 were included in this study. A total of 66 patients had an adequate follow-up time of over 6 months. Patient satisfaction and postoperative complications were recorded. The majority of the patients (57/66 cases) were satisfied with the results of the procedure. The authors believe that the addition of the footplate incision in esthetic rhinoplasty is safe and reliable for effecting better results for Asians.

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Section: Discussionmentioning

confidence: 71%

Advantages of Adding a Footplate Incision in Asian Rhinoplasty

Han¹,

Ko²,

Kim³

2004

Annals of Plastic Surgery

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“…Nevertheless, potential complications, such as infection, extrusion, contraction, and delayed inflammation, lead to preferences for autologous materials over silicone [ 10 ]. The risk of complications after augmentation rhinoplasty with silicone implants has been reported to vary greatly from study to study, from 4% to 24% [ 8 9 11 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Complications related to silicone implants, such as discoloration, dislocation, extrusion, contraction resulting from a foreign body reaction, and infection have been reported [ 12 ]. Among the major complications requiring either removal or revision of the prosthesis, only 2.5% occurred early, within 30 days of the procedure [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Contracted Nose after Silicone Implantation: A New Classification System and Treatment Algorithm

et al. 2017

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BackgroundSilicone implants are frequently used in augmentation rhinoplasty in Asians. A common complication of silicone augmentation rhinoplasty is capsular contracture. This is similar to the capsular contracture after augmentation mammoplasty, but a classification for secondary contracture after augmentation rhinoplasty with silicone implants has not yet been established, and treatment algorithms by grade or severity have yet to be developed.MethodsPhotographs of 695 patients who underwent augmentation rhinoplasty with a silicone implant from May 2001 to May 2015 were analyzed. The mean observation period was 11.4 months. Of the patients, 81 were male and 614 were female, with a mean age of 35.9 years. Grades were assigned according to postoperative appearance. Grade I was a natural appearance, as if an implant had not been inserted. Grade II was an unnatural lateral margin of the implant. Clearly identifiable implant deviation was classified as grade III, and short nose deformation was grade IV.ResultsGrade I outcomes were found in 498 patients (71.7%), grade II outcomes in 101 (14.5%), grade III outcomes in 75 (10.8%), and grade IV outcomes in 21 patients (3.0%). Revision surgery was indicated for the 13.8% of all patients who had grade III or IV outcomes.ConclusionsIt is important to clinically classify the deformations due to secondary contracture after surgery and to establish treatment algorithms to improve scientific communication among rhinoplasty surgeons. In this study, we suggest guidelines for the clinical classification of secondary capsular contracture after augmentation rhinoplasty, and also propose a treatment algorithm.

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“…29 Two studies looking at 1000 and 2500 cases of Asian rhinoplasty found a combined infection/ extrusion rate as low as 0.48 percent. 30,31 The dorsal nasal skin in Asian patients tends to be thicker than in Caucasian noses, which may provide better soft-tissue pockets, thereby allowing improved support of a Silastic framework with lower overall complication profiles. 32 It has been suggested that higher rates of extrusion may be related more to lack of surgeon experience and implant design.…”

Section: Siliconementioning

confidence: 99%

Optimizing the Use of Autografts, Allografts, and Alloplastic Materials in Rhinoplasty

Chen

Schultz

Mattos

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Rhinoplasty continues be one of the most popular cosmetic procedures performed in the United States, with over 200,000 procedures performed in 2019 alone. As surgeons have realized the importance of maintaining structural integrity of the tip and dorsum, the landscape of rhinoplasty dogma has shifted from reductive techniques alone to include frequent use of grafts and implants and even toward maintaining all structure with preservation rhinoplasty techniques. Grafts and implants allow for resistance of both static forces from gravity and aging, and dynamic forces from tissue contraction/scarring, paranasal muscles, and the pressure changes from normal breathing.With this increased use of grafts comes an increased demand on cartilage. Septum is the standard of graft material; however, with quoted rates of revision rhinoplasty at 10 to 15 percent, septal cartilage is frequently unavailable if previously harvested. 1 The question then arises as to the source of sufficient cartilage to fulfill the structural needs of the rhinoplasty. Other sources of autograft are available, such as conchal or rib cartilage, but their use must be balanced against their donor-site morbidity. Allografts have thus gained popularity. Ten years ago, the only option for cartilage allograft was irradiated rib cartilage. However, modern processing techniques have made fresh cadaveric rib cartilage a viable and relatively cost-effective option.This review discusses the current and most common options available for graft source and implant material and the techniques in graft/ implant choice and placement in both primary and revision rhinoplasties. With this noncomprehensive overview, the authors hope to elucidate techniques that can allow the surgeon to deliver stable, reproducible nasal architecture with a foundational construct that yields optimal aesthetic and functional outcomes.

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The classification of complications after augmentation rhinoplasty

Cited by 35 publications

References 2 publications

Advantages of Adding a Footplate Incision in Asian Rhinoplasty

Advantages of Adding a Footplate Incision in Asian Rhinoplasty

Contracted Nose after Silicone Implantation: A New Classification System and Treatment Algorithm

Optimizing the Use of Autografts, Allografts, and Alloplastic Materials in Rhinoplasty

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