Total Skeletal Reconstruction of the Nasal Dorsum

Abstract

Objective: To review the outcomes of rhinoplasty in patients who underwent full-length dorsal reconstruction.Design: Retrospective review.Setting: Private-practice facial plastic surgery clinic.Patients: Thirty-seven patients in a consecutive series of 1273 rhinoplasty cases.Interventions: In all patients, a single high-density porous polyethylene implant was used to span the full length of the nasal bridge as part of their rhinoplasty reconstruction.Main Outcome Measures: Retrospective review of medical charts and preoperative and postoperative photographs to identify any complications, including infection, extrusion, movement, or displacement, and examination of the aesthetic outcome. A telephone survey was performed to assess patient satisfaction regarding the appearance and sensation of the nose.Results: In all cases, the full-length dorsal implant provided a smooth bridge contour without leaving an inverted V deformity or focal irregularities. There were no cases of infection or extrusion. In 2 cases, revision surgery was required to enhance cosmetic outcome. Conclusions:The high rate of patient acceptance, safety, and success of full-length dorsal reconstruction in providing a natural frontal contour challenges the minimal indications for using this type of reconstruction as opposed to using smaller grafts. As with all alloplasts, longterm follow-up is required.

Promising Implants in Rhinoplasty

“…22 Furthermore, localized firmness and numbness have been described. 23 Building upon these experiences, developments have been made in implant materials for rhinoplasty focused on resorbable options, low profile but supportive implants, and materials that mimic the composition native cartilage. We will further focus our discussion on promising implants utilized in rhinoplasty.…”

Saddle Nose Deformity Reconstruction With a Split Calvarial Bone L-Shaped Strut

“…Several of these materials, however, enable favorable incorporation of soft tissue into the material itself, in theory, providing a more natural appearance. Thornton and Mendelsohn17 described the use of a 1-dimensional piece of high-density porous polyethylene to reconstruct the nasal dorsum. The rough inner surface of the material obviates the need for rigid fixation, and the porous material enables ingrowth of natural tissue over time, providing additional stability.…”