Nasal Implants

Abstract

In this article, options for nasal implantation during rhinoplasty are discussed. The range of implant options currently available to the nasal surgeon is considered in detail. Various types of autografts, homografts, and alloplasts commonly used in the nose are introduced and described. Indications for each nasal implant type are considered, as are the advantages and limitations of each option.

Long-term Use and Follow-up of Irradiated Homologous Costal Cartilage Grafts in the Nose

“…The primary disadvantages to the use of synthetic alloplastic implants are the foreign body response and higher rates of infection and extrusion. [2][3][4] Autografts are usually the material of choice, with lower rates of tissue reaction, resorption, and infection than with alloplasts. Other, less favorable, options include the use of calvarial bone graft for dorsal augmentation, but these grafts lack any flexibility and often need to be drilled to be secured in place.…”

“…5,6 Autogenous cartilage (AC) grafts are alternative options and can be obtained from the nasal septum or the auricular concha for smaller defects and from rib cartilage for larger defects. [2][3][4]7 Experimental transplantation of cartilage in modern time was initiated by Bert in 1865. 8 Autogenous cartilage transplant in humans was also performed by Koenig in 1896, 9 followed by a successful rhinoplasty using rib cartilage by Von Mangoldt in 1900.…”

“…Grafting with alternative implant materials then becomes necessary in order to restore functional integrity and volume. 4,35 Most of the IHCC grafts were obtained either from the University of Texas Health Science Center at Dallas and a lesser amount from the Northern California Tissue Bank, San Francisco. The rib cartilage pieces used in the present study were treated with gamma irradiation (15-24 kGy for 1.5-2.0 hours) and were stored in saline in a sealed, sterile container.…”

Polypropylene meshes and other alloplastic implants for soft tissue and cartilage nasal reconstructive surgery – a literature review

“…Porous implants have a smaller proportion of empty space in comparison to meshed implants. They allow host tissue ingrowth that provide stability, but the ingrowth is lower than of the meshed implants; so, the implant removal, if needed, is less complicated 8 . There are many options regarding the alloplastic materials in nasal surgery, but it must be reinforced that the ideal nasal implant is an autogenous implant and the allogenic polymers must be used with great care 8 .…”

“…It is also used for the augmentation of the dorsum nasi 22 . Polyester mesh (Mersilene ® ) is preferred as nasal implant in some studies, even if it has a 3.5% infection rate 8 .…”