Complications associated with Alloplastic Materials in Rhinoplasty and their operative Management – our Experiences

Objective While classical rhinoplasty with reduction of the nasal dorsum and modification of the nasal tip is the most common procedure among Caucasians, the augmentation of the nasal dorsum remains the main challenge in the Asian population. The choice of the ideal grafting material for the dorsal augmentation is a matter of preference and remains a matter of discussion. Autologous as well as alloplastic materials have their advantages and disadvantages. We report on our experiences of extrusion of alloplastic materials and their management pre- intra and postoperatively. Methods 15 patients were included in this retro and prospective multicentre study, who underwent rhinoplasty surgery in the past for dorsal augmentation with alloplastic material. Thirteen of fifteen patients underwent augmentation rhinoplasty in Asia. Only two patients received alloplastic material in Germany. Results In all patients we could perform a one stage operative procedure with explantation of the alloplastic material and reconstruction via rib cartilage after a preoperative intravenous antibiotic therapy. The allogenous material included mainly silicone or Medpore. Augmentation of the nasal dorsum was performed with either solid rib cartilage grafts, diced cartilage in fascia or free diced cartilage in PRF. All patients received perioperative and postoperative antibiotics. The outcome was screened via clinical examination, ultrasound, 3D imaging and MRI scans. Conclusion The extrusion of foreign body material for the augmentation of the nasal dorsum is rare and remains a challenge due to uncontrolled scaring, infections and often unsatisfying results. We could show a series of satisfying results after single stage reconstruction with good postoperative screening tools. Legerlotz Stiftung Publication History Article published online: 12 May 2023 Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany