Objective: To evaluate the incidence of infection and extrusion of porous high-density polyethylene (pHDPE) and expanded polytetrafluoroethylene (ePTFE) implants used in rhinoplasty at a high-volume, academic facial plastic surgery practice.Methods: A total of 662 rhinoplasty procedures performed by 3 faculty surgeons from 1999 to 2008 were retrospectively reviewed. Patient demographics, medical comorbidities, operative details, and postoperative course findings were collected from patient records.Results: The incidence of postoperative infection was 2.8% (19 of 662 patients). In each case of infection, alloplastic material had been used. Infections occurred in 1 in 5 rhinoplasty procedures in which pHDPE implants were used. In patients in whom ePTFE was used alone, the infection rate was 5.3%. Exposure developed in 12% of patients in whom an alloplast was used during surgery. Factors notably not associated with infection on bivariate analysis included sex, surgeon, purpose of procedure (functional vs cosmetic), current tobacco use, or history of cocaine use (P Ͼ .05 for all).Conclusions: To our knowledge, this study represents the largest evaluation of the use of pHDPE implants in rhinoplasty to date. Our findings are in contrast to those of previous studies regarding the use of pHDPE in rhinoplasty and parallel to those regarding the use of ePTFE. Caution is strongly recommended when considering the use of pHDPE in rhinoplasty.

Alloplasts continue to be a controversial option in rhinoplasty. The surgeon must be cognizant of the risks and benefits of their use. A frank preoperative discussion of possible complications with the patient is important. Additionally, prompt recognition and appropriate management of complications is essential to minimize permanent sequelae.

Objectives: The nasal tip is the most prominent part of the nose. The aim of this paper is to review nasal tip grafts with detailed explanation and figures. Methods: The authors searched PubMed, Google, Google Scholar, and Proquest Central database of the Kirikkale University. Search was performed with the key words of “nasal,” “tip,” “graft.” The indications and grafting techniques were presented. Results: The external shape of the nasal tip is determined by the curves and contours of the lower lateral cartilages and their interactions with the surrounding tissues. Normative data exist regarding the ideal shape and shadowing of the nasal tip. The mainly used tip grafts in rhinoplasty are “Floating graft (Goldman) ,” “Tip Onlay Graft,” “Columellar Strut Graft,” “Caudal Septal Extension Graft,” “Shield Graft,” “Alar batten onlay graft,” “Lateral Crural Strut Grafts,” “Alar rim grafts.” Conclusion: When tip sutures are not enough, cartilage tip grafts offer a versitile and effective way to change the nasal tip. While there has been a vast array of grafting techniques described, this paper reviewed many of the most popular and useful grafts in modern use.

Many dilemmas in rhinoplasty tempt surgeons to use exogenous materials. We have long looked toward implants to decrease operative time, to achieve a more reliable result, or when there is a paucity of autologous material. More than ever, the innovative and highly lucrative field of nasal implantology is developing technologically advanced products. This article looks at some popular nasal implant choices with a look toward what might be on the horizon.

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