The Use of Alloplastic Materials in Rhinoplasty Surgery: A Meta-Analysis

Peled, Ziv M.; Warren, Anne G.; Johnston, Patrick; Yaremchuk, Michael J.

doi:10.1097/01.prs.0000299386.73127.a7

Cited by 146 publications

(111 citation statements)

References 53 publications

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“…53,60 The possible complications, with potential rates of occurrence and when they may be expected to occur, should be discussed prior to surgery. 73 Rhee et al found that the distribution of the overall complications included intranasal synechiae (14%), infection (9%), graft resorption (7%), and residual septal deviation (7%). 60 Other reported complications included failure to improve nasal airway patency, residual external deformity, hematoma, graft dislocation/migration, septal perforation, vestibulitis, and tissue reaction to alloplastic materials, as well as the lack of subjective improvement of the underlying condition.…”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Ishii

Tollefson

Basura

et al. 2017

Otolaryngol.--head neck surg.

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Objective. Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work.The resultant psychological impact of rhinoplasty can also be significant. Furthermore, the health care burden from psychological pressures of nasal deformities/aesthetic shortcomings, surgical infections, surgical pain, side effects from antibiotics, and nasal packing materials must also be considered for these patients. Prior to this guideline, limited literature existed on standard care considerations for pre-and postsurgical management and for standard surgical practice to ensure optimal outcomes for patients undergoing rhinoplasty. The impetus for this guideline is to utilize current evidence-based medicine practices and data to build unanimity regarding the peri-and postoperative strategies to maximize patient safety and to optimize surgical results for patients.Purpose. The primary purpose of this guideline is to provide evidence-based recommendations for clinicians who either perform rhinoplasty or are involved in the care of a rhinoplasty candidate, as well as to optimize patient care, promote effective diagnosis and therapy, and reduce harmful or unnecessary variations in care. The target audience is any clinician or individual, in any setting, involved in the management of these patients. The target patient population is all patients aged ≥15 years. The guideline is intended to focus on knowledge gaps, practice variations, and clinical concerns associated with this surgical procedure; it is not intended to be a comprehensive reference for improving nasal form and function after rhinoplasty. Recommendations in this guideline concerning education and counseling to the patient are also intended to include the caregiver if the patient is <18 years of age.Action Statements. The Guideline Development Group made the following recommendations: (1) Clinicians should ask all patients seeking rhinoplasty about their motivations for surgery and their expectations for outcomes, should provide feedback on whether those expectations are a realistic goal of surgery, and should document this discussion in the medical record. (2) Clinicians should assess rhinoplasty candidates for comorbid conditions that could modify or contraindicate surgery, including obstructive sleep apnea, body dysmorphic disorder, bleeding disorders, or chronic use of topical vasoconstrictive intranasal drugs. (3) The surgeon, or the surgeon's designee, should evaluate the rhinoplasty candidate for...

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Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty

Ishii

Tollefson

Basura

et al. 2017

Otolaryngol.--head neck surg.

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“…It is known to be non-antigenic, non-allergenic, and can be carved to various shapes [6]. However, some studies suggest that using Medpor for nasal augmentation is not recommended because of its variable and unpredictable resorption rate [7,8]. In our experience, Medpor is difficult to remove during revision rhinoplasties.…”

Section: Graft Materialsmentioning

confidence: 75%

Nasal tip surgery: nasal lengthening and augmentation in Asian rhinoplasty

Jung¹,

Tan²,

Jin³

2017

J Cosmet Med

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“…[3] and extrusion rates, ranging from 3.1% [4] to as high as 21% [5] and often require removal, which can be extremely difficult because of tissue incorporation. [5,6] Explantation surgery is treacherous as there is a high incidence of button holing, thinning, and irregularity of overlying skin and damage to surrounding structures.…”

Section: These Implants Have High Infection (3-4%)mentioning

confidence: 99%