Dorsal Augmentation in Rhinoplasty: A Survey and Review

Abstract

Understanding the nuanced practices and grafting options of dorsal augmentation will improve outcomes and results in rhinoplasty. To better understand the practices of dorsal augmentation among our colleagues. To review the current literature regarding the indications, safety profiles, and outcomes of different materials used in dorsal augmentation. A PubMed search was performed to capture current articles containing reviews or large series regarding the safety and efficacy of various grafting materials used for dorsal augmentation. Of the many options available, autologous cartilage grafts maintain widespread use for dorsal augmentation and other techniques in rhinoplasty. Homologous cartilage grafts, namely irradiated rib, are a preferred alternative. Irradiated costal cartilage has been shown to have low complication rates and is unique in its abundance of supply, particularly in the revision rhinoplasty. Alloplastic implants, particularly silicone, are prevalent in Asian countries where they are a popular first-line choice. ePTFE has a favorable complication profile in primary rhinoplasty; however, caution is recommended when using ePTFE in revision cases. Porous polyethylene has a higher risk of associated complications than the other alloplastic implants listed, and therefore should be considered thoughtfully. Although cartilage is often the preferred graft for dorsal augmentation, there are many other autogenous, homologous, and alloplastic materials that have been shown to be safe and effective choices when applied in the proper setting.

Preoperative Simulation in Planning Rhinoplasty: Evaluation from Patients' and Surgeons' Perspectives

“…Notwithstanding, online surveys have been effectively used in many scientific studies published in prominent journals and we believe that once pertinently structured, an online survey can provide results as valid and reliable as an in-person one. 13,14 In conclusion, it has been observed that patients are influenced by visual factors (the factors that they directly see with their eyes, such as simulation results, pre-and postoperative photographic result, and meeting a previously operated patient by the same surgeon) when deciding on a rhinoplasty procedure and find the surgical outcome of an experienced surgeon more appealing than a simulation. Also, there is an evident consciousness among potential rhinoplasty patients regarding the use of preoperative simulations which is likely to increase their demand in future, mandating more surgeons to use them.…”

Safety and Efficacy of Cosmetic Augmentation of the Nasal Tip and Nasal Dorsum With Expanded Polytetrafluoroethylene

“…Extrusion rates of silicone implants typically range from 2.1% to 3.7%. 3 Lam and Kim 25 used an L-shaped silicone implant to provide dorsal and tip augmentation. However, owing to the characteristics of silicone, the implant could appear to be unnatural and extruded if the columella portion of the implant was too pronounced.…”

A systematic review of complications associated with nasal augmentation implants: expanded polytetrafluoroethylene (Gore-Tex) versus silicone

“…One may argue that a rhinoplasty specialist may have a lower rate; however, it is difficult to truly assess, as patients often change surgeons or even go to different cities and different countries to have cosmetic surgeries performed. In Asian rhinoplasty, augmentation is a key part of the surgery, and implants are used almost exclusively in Asia, particularly for primaries [1][2][3][4][5]. Both silicone and Values are presented as number.…”

“…The augmentation rhinoplasty procedure has long been one of the most common cosmetic procedures in Asian populations [1][2][3], and silicone is the most widely used nasal augmentation material in Asia [2][3][4][5]. How-www.jcosmetmed.org ever, in the past few decades, expanded polytetrafluoroethylene expanded polytetrafluoroethylene (ePTFE, Gore-Tex ® ) has become more popular as an alternative implant [2][3][4][5]. Both implant materials have been used for decades in plastic and cardio-vascular surgery, and they both have excellent biocompatibility profiles.…”