title: Immediate autogenous cartilage grafts in rhinoplasty after alloplastic implant rejection.
abstract: BACKGROUND
  It is accepted in rhinoplasty that complications are more common with alloplastic implants than with autografts. There is little guidance in the literature on how to deal with the cosmetic and/or functional problems that follow alloplastic implant rejection. The conventional advice has been to remove the allograft and not place any graft at the same time. The present article presents our experience treating allograft rejection and immediately repairing any structural defect with autografts.
  
  
  OBJECTIVE
  To demonstrate that immediate nasal reconstruction using autogenous cartilage is a good technique when an alloplastic material has to be removed because of rejection, inflammation, or infection.
  
  
  METHODS
  A retrospective analysis of outcome for a case series.
  
  
  METHODS
  A retrospective review of the management of 8 patients who presented to 2 tertiary referral centers with alloplastic implant rejection following rhinoplasty. In 7 cases, the alloplastic implant had to be removed because it had migrated and caused a foreign body reaction; in 1 case, the implant had caused a bacterial infection.
  
  
  RESULTS
  In all 8 cases, the nasal deformity that followed the removal of the allograft was so marked that the nose was immediately reconstructed with autogenous cartilage. The patients all made a good recovery after immediate reconstruction, although skin changes associated with the alloplastic implant remained after a mean follow-up of 3 years 3 months.
  
  
  CONCLUSIONS
  The use of autogenous cartilage is a good option for nasal augmentation immediately after the removal of an alloplastic implant.
authors.affiliation: Queen's Medical Centre, University Hospital, Nottingham, England.
authors.forename: Ullas
authors.initials: U
authors.lastname: Raghavan
authors.forename: Nick S
authors.initials: NS
authors.lastname: Jones
authors.forename: Thomas
authors.initials: T
authors.lastname: Romo
mesh_terms: D000328:Adult; D002356:Cartilage / Q000637:transplantation; D020878:Device Removal; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery; D005549:Foreign-Body Reaction / Q000209:etiology / Q000601:surgery; D006084:Graft Rejection / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009666:Nose; D009667:Nose Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D019736:Prostheses and Implants / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome