“Ride-on” technique and other simple and logical solutions to counter most common complications of silicone implants in augmentation rhinoplasty

Abstract

Augmentation rhinoplasty can be carried out using a wide range of materials including autologous bone and/or cartilage as well as alloplasts. Use of biologic bone and cartilage grafts results in lower infection rates, but they are associated with long-term resorption and donor-site morbidity. Alloplastic materials, in particular silicone, have been associated in literature with extrusion, necrosis of the tip, mobility and deviation or displacement of the implant, immobile nasal tip and infection. However, they have the advantages of being readily available and easy to reshape with no requirement for harvesting autografts.Aim:To overcome these problems associated with silicone implants for which the authors have devised a novel technique, the “rideon technique”.Materials and Methods:The present study was carried out on 11 patients over a period of 4 years. The authors have devised a simple technique to fix the silicone implant and retain it in place. Restricting the implant to only dorsum avoided common complications related to the silicone implant.Results:The authors have used this technique in 11 patients with encouraging results. Follow-up ranged from 12 months to 36 months during which patients were assessed for implant mobility, implant extrusion and tip necrosis. There was no incidence of above mentioned complications in these patients.Conclusion:The “rideon technique” provides excellent stability to silicone implants and restricting the implant only to dorsum not only eliminates chances of tip necrosis and thus implant extrusion but also maintains natural shape, feel and mobility of the tip.

The current techniques in dorsal augmentation rhinoplasty: a comprehensive review

“…A short nose correction depends mainly on the skin's condition [ 32 ]. The ride-on technique (sutured cartilage or perichondrium onto a silicone surface) also reduces implant extrusion rates and maintains the natural mobility of the tip, according to Agrawal et al (2015) [ 101 ].…”

Advancements in craniofacial prosthesis fabrication: A narrative review of holistic treatment

“…Nasal prostheses may also serve a functional purpose, especially if the affected area involves the maxilla or the palate. In such cases, design of the nasal prosthesis and retention should take into consideration any other prosthodontic rehabilitations the patient may need 40. Likewise, patient confidence in such prostheses is diminished when retention is inadequate 41.…”

“…Oil-based paints are used to customize the prosthesis for the patient according to skin appearance. At the final appointment, cyanoacrylate is used to adhere the prosthesis to spectacles and water-resistant color is added to create a life-like, polychromatic prosthesis 40. Finally, texture adjustments are made to match the skin surface.…”