Alloplastic materials in rhinoplasty.

PURPOSE OF REVIEW

This review examines implant materials currently used in rhinoplasty. In revision cases, the most desirable autogenous grafts from the septum are often unavailable in adequate quantities. The 'ideal' implant has strict requirements concerning biocompatibility, plasticity, stability of form, resistance to infection, and removability.

RECENT FINDINGS

Silicone implants continue to be used in spite of frequent reports of rejection. In spite of its described absorption, conserved cartilage can help in preserving profiles. Increasingly, good results are being reported with porous polyethylene, although Proplast is sometimes used in its place. Despite the fact that AlloDerm is partially absorbed, it can still be useful. GoreTex is effective for smaller defects. Mersilene mesh is not absorbed and retains its stability of shape. 'Turkish Delight' (diced cartilage with a wrapping) seems to be absorbed when the wrapping is made of Surgicel, but a wrapping of autogenous fascia provides lasting results.

SUMMARY

Several alloplastic materials do have a place in nasal surgery. Provided that the correct techniques are employed, side effects from their use are no greater than the complications resulting from the use of autogenous costal cartilage, with the intervention necessary for its harvesting.