Surgical Nasal Implants: Indications and Risks.
Rhinoplasty often requires the use of grafting material, and the goal of the specific graft dictates the ideal characteristics of the material to be used. An ideal material would be biologically inert, resistant to infection, noncarcinogenic, nondegradable, widely available, cost-effective, readily modifiable, and easily removable, have compatible biomechanical characteristics, retain physical properties over time, and not migrate. Unfortunately, no material currently in existence meets all of these criteria. In modern rhinoplasty, autologous grafts are the gold standard against which all other nasal implants are measured and offer the safest long-term results for most patients. They are easily manipulated, have inherent stability and biomechanical characteristics similar to the native nasal framework, and confer minimal risk of complications. Modern homologous and alloplastic materials have gained considerable support in recent years because they are readily available in endless quantity, do not require a second surgical site for harvest, and are generally considered safe if most circumstances, but they confer additional risk and have biomechanical characteristics different from that of the native nasal framework. To address some of these issues, we provide a contemporary review of autologous, homologous, and alloplastic materials commonly used in rhinoplasty surgery.
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Dane J
DJ
Genther
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ira D
ID
Papel
D001672:Biocompatible Materials / Q000009:adverse effects; D016025:Bone Transplantation; D002356:Cartilage / Q000637:transplantation*; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D018579:Patient Selection; D020959:Polyethylene; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants / Q000009:adverse effects / Q000266:history; D012225:Rhinoplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D012307:Risk Factors; D012828:Silicones; D014184:Transplantation, Homologous
D001672:Biocompatible Materials; D012828:Silicones; D011138:Polytetrafluoroethylene; D020959:Polyethylene