Paranasal Augmentation Using Multi-Folded Expanded Polytetrafluorethylene (ePTFE) in the East Asian Nose

Abstract

Background Paranasal augmentation has commonly been performed utilizing alloplastic materials such as silicone or porous polyethylene. However, there are problems such as bone absorption, implant migration, and infection risk attributable to intraoral approaches. Objectives The authors attempted anterior positioning of the alar crease junction as an adjunct method of rhinoplasty. The authors aimed to determine the long-term results of the intranasal approach for placement of multi-folded expanded polytetrafluorethylene (ePTFE). Methods A retrospective review was conducted of patients who underwent intranasal surgical approach for paranasal augmentation employing multi-folded ePTFE implants in 19 septorhinoplasties who were followed-up for 3 to 10 years. Patient charts were reviewed for demographic information, concomitant operations, and complications. Preoperative and postoperative photographs were utilized to evaluate operative outcomes. The photographs were reformatted to 2-dimensional images employing standard photographic methods. Results Of the 19 patients treated, 17 were female and 2 were male; ages ranged from 18 to 58 years. All patients reported improvement in their lateral profiles and were pleased at follow-up. There were no major complications, no nerve or vascular supply compromise, and no cases of implant malposition. The average increase in soft tissue outline near the alar crease junction was more than 3.2 mm (P < 0.001), but the alar base did not became wider. Conclusions Paranasal augmentation with multi-folded ePTFE is a simple, safe, and effective method that can readily improve the lateral profile. In particular, the intranasal approach combined with rhinoplasty can synergistically improve outcomes and lead to greater patient satisfaction. Level of Evidence: 4

Paranasal Augmentation Using Diced Costal Cartilage for Midface Concavity: A Retrospective Study of 68 Patients

“…That may be the reason for the different satisfaction rates between the patients and doctors (75% vs. 98.5%). Although patient satisfaction rate of paranasal augmentation here (75%) was lower compared with porous polyethylene, expanded polytetrafluorethylene, or cartilage reported in previous studies (nearly 100%), the relatively small sample sizes in these studies (usually less than 30 patients) may lead to a certain bias and limit the statistic power [2,15,22]. In a study of 93 patients who underwent paranasal augmentation with silicone, 79 (84.9%) patients were satisfied with the aesthetic outcomes with two patients requiring immediate implant removal due to discomfort, three patients experiencing implant migration, and nine patients complaining of paresthesia [2].…”

Application of Paranasal Augmentation Rhinoplasty in Asians With Midfacial Concavity

“…The stability of the implant is good, and the satisfaction with the patient is high. 1,6,7 Therefore, for patients who undergo comprehensive rhinoplasty with midfacial concavity, paranasal augmentation has a multiplier effect.…”

“…To address this issue, there have been reports of paranasal augmentation. Paranasal augmentation can increase the projection of the nasal tip, significantly reduce the protrusion of the upper lip, and increase the nasolabial angle 1–4 . These treatments significantly increased the satisfaction of comprehensive rhinoplasty and tremendously improved the midfacial concavity.…”

ePTFE‐based biomedical devices: An overview of surgical efficiency

“…Gu et al in 2018, reported the efficient, safe, and little‐studied solution of using ePTFE as nasal tip and dorsum augmentation, in a randomized clinical trial 124 . Out of a sample of 150 people seeking rhinoplasty, 129 were eligible for dorsum and tip nose augmentation.…”

“…The results lead to the conclusion that the cartilage used as a shield is not required and the ePTFE used alone for nasal tip and dorsum augmentation is a new technique that can be used safely with high levels of acceptable success. Paranasal augmentation with multi‐folded ePTFE is also a technique that has been shown to be clinically safe and effective with a follow‐up of 3 to 10 years 124 …”