Joon Pio Hong1, Ji Young Yoon, Jong Woo Choi. 1. Department of Plastic and Reconstructive Surgery, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea.
Abstract
BACKGROUNDS: Augmentation rhinoplasty is a relatively common procedure in Korea. Alloplastic materials such as silicone, supramid mesh, Proplast, Mersiline, Medpor, and hydroxyapatite are frequently used for dorsal augmentation. Alloplastic implants have advantages, such as ready availability and no donor-site morbidity, but are associated with higher infection and extrusion rates than are autogenous materials. Although polytetrafluoroethylene (Gore-Tex) implants have recently been introduced, such implants are yet to be established as an alternative for nasal augmentation because of a lack of relevant reports. METHODS: From March 1998 to March 2007, we operated on 873 nasal dorsum augmentation patients using hard-type Gore-Tex implants. The patients were all of Korean ethnicity. There were 826 female and 47 male patients and aged ranging from 18 to 57 years (mean, 24 y). The Gore-Tex implant thicknesses were 3.1 to 4.9 mm (used in 59% of cases), 2 to 3 mm (8%), or 5 to 6 mm (33%). The Gore-Tex implants were used only for dorsal augmentation, whereas conchal or septal cartilage was used for nasal tip plasty. RESULTS: Of the total of 873 patients, 257 received long-term follow-up (mean follow-up, 34 mo). Apart from 34 patients with revision, no patient reported dissatisfaction, and there were no reports of problems with nasal contour, implant migration, or resorption of the implant material. The overall complication rate was 3.8%. Of the 257 long-term follow-up patients, 34 (13.5%) required revision. Four of these patients involved minor complications that were managed conservatively, whereas 30 patients required implant removal and revision procedures. These 30 cases included irregularity, infection, deviation, unfavorable dorsum height, and apparent implant silhouette, in addition to obvious supratip deformity. A review of the literature revealed that Gore-Tex implants seemed to have a lower implant removal rate than silicone implants. However, the overall complication rates seemed to be similar when Gore-Tex and silicone implants were used for nasal dorsum augmentation in Asian patients. We found that Gore-Tex implants were effective and safe for use in primary and revision rhinoplasty in Asians. Gore-Tex implants seem to have an overall complication rate similar to that of silicone implants. Thus, Gore-Tex can be considered as an alternative material for dorsal augmentation rhinoplasty but turned out not to have definite advantages over the silicone implants.
BACKGROUNDS: Augmentation rhinoplasty is a relatively common procedure in Korea. Alloplastic materials such as silicone, supramid mesh, Proplast, Mersiline, Medpor, and hydroxyapatite are frequently used for dorsal augmentation. Alloplastic implants have advantages, such as ready availability and no donor-site morbidity, but are associated with higher infection and extrusion rates than are autogenous materials. Although polytetrafluoroethylene (Gore-Tex) implants have recently been introduced, such implants are yet to be established as an alternative for nasal augmentation because of a lack of relevant reports. METHODS: From March 1998 to March 2007, we operated on 873 nasal dorsum augmentation patients using hard-type Gore-Tex implants. The patients were all of Korean ethnicity. There were 826 female and 47 male patients and aged ranging from 18 to 57 years (mean, 24 y). The Gore-Tex implant thicknesses were 3.1 to 4.9 mm (used in 59% of cases), 2 to 3 mm (8%), or 5 to 6 mm (33%). The Gore-Tex implants were used only for dorsal augmentation, whereas conchal or septal cartilage was used for nasal tip plasty. RESULTS: Of the total of 873 patients, 257 received long-term follow-up (mean follow-up, 34 mo). Apart from 34 patients with revision, no patient reported dissatisfaction, and there were no reports of problems with nasal contour, implant migration, or resorption of the implant material. The overall complication rate was 3.8%. Of the 257 long-term follow-up patients, 34 (13.5%) required revision. Four of these patients involved minor complications that were managed conservatively, whereas 30 patients required implant removal and revision procedures. These 30 cases included irregularity, infection, deviation, unfavorable dorsum height, and apparent implant silhouette, in addition to obvious supratip deformity. A review of the literature revealed that Gore-Tex implants seemed to have a lower implant removal rate than silicone implants. However, the overall complication rates seemed to be similar when Gore-Tex and silicone implants were used for nasal dorsum augmentation in Asian patients. We found that Gore-Tex implants were effective and safe for use in primary and revision rhinoplasty in Asians. Gore-Tex implants seem to have an overall complication rate similar to that of silicone implants. Thus, Gore-Tex can be considered as an alternative material for dorsal augmentation rhinoplasty but turned out not to have definite advantages over the silicone implants.