The Use of AlloDerm for the Correction of Nasal Contour Deformities

Abstract

What rhinoplasty surgeon has not been frustrated by unmet expectations from unreliable graft materials? The quest for an ideal graft continues. Septal cartilage is not always adequate in amount or substance. Ear cartilage may cause unsightly irregularities over time. Cranial bone or rib harvest sites add to the complexity of the procedure and can be intimidating for many operators. This article describes the authors' successful experience with AlloDerm onlay grafts for the correction of nasal contour deformities in 58 primary and secondary rhinoplasty cases by means of the open and endonasal approaches. Forty-two patients received an open-approach procedure; the remaining 16 received grafting through an endonasal or closed approach. Thirty-seven of the patients were secondary rhinoplasty patients, and some underwent multiple nasal corrections. The indications, intraoperative surgical technique of graft placement, and representative results will be discussed. Long-term follow-up showed good results, though partial graft resorption occurred in some patients. Overall, this experience with AlloDerm for nasal augmentation was encouraging.

Rhinoplasty and the Nasal SMAS Augmentation Graft

“…Unfortunately, despite its favorable immunologic and physical properties, the long-term fate of acellular dermis is highly unpredictable, as volume persistence in humans falls to less than 50% within 3 months of implantation. 9 Although anecdotal reports suggest that acellular dermis may effectively eliminate minor contour irregularities despite partial resorption, 11,12 cost considerations and the theoretical potential for transmission of infectious disease have been a deterrent to the use of acellular dermis in some patients.…”

Biochemical, Biophysical and Mechanical Characterization of Decellularized Dermal Implants

“…Allografts and xenografts have grown appreciably in their use in applications that include: bladder regeneration [3], burns [4], breast reconstruction [5], facial cosmetic defects [6], free flap coverage [7], hernias [8], ophthalmic defects [9], oral defects [10], replacement of cardiovascular tissues [11], tendon/ligament repair [12], and vaginal repair [13]. They also have been used as replacements in the repair of rotator cuff, Achilles and quadriceps tendons, primary staged and revised breast reconstruction, hernia repair, treatment of chronic wounds such as diabetic foot ulcers and pulmonary patches [14] [15] [16].…”

Comparison of Autogenous Cartilage, Acellular Dermis, and Solvent-Dehydrated Pericardium for the Prevention and Correction of Dorsal Nasal Irregularities: An Experimental Study

“…In patients with thin skin, graft materials are occasionally used in primary rhinoplasty procedures for the prevention of visible dorsal nasal irregularities [1][2][3][4][5][6]. Cartilage, dermis, temporal fascia, superficial musculoaponeurotic system (SMAS), Vicryl mesh, gelatin film, polytetrafluoroethylene, Surgicel-wrapped diced and crushed cartilage, tensor fascia lata, and acellular dermis are among the most commonly used materials to correct contour deformities and provide a subcutaneous pad [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Each material has certain advantages and disadvantages but a controversy about the ''best material'' still exists.…”