Alloplast as an alternative for dorsal augmentation.

With an ever increasing ethnic population in the United States, dorsal augmentation has become a fairly common accompaniment to rhinoplasty. But procurement of adequate graft material of suitable nature and amount persists as a challenge to plastic surgeons. This dilemma has become even more pressing in recent years as a variety of other exceptional graft applications for the patient's limited cartilage bank have become not just an option but also mandatory for our higher expectations. The debate of the past century over alloplast in the dorsum persists in the present. "When and if ever" is the commonly asked question. Surely, no alloplast can match the ideal graft, but no graft is ideal either as it always comes in limited supply. There is now more than 15 years of experience with expanded polytetrafluoroethylene in the nose. It appears that with proper patient selection and technique, expanded polytetrafluoroethylene can be used in the nasal dorsum with relatively low complication rates and high patient satisfaction.