Semin Plast Surg 2008; 22(2): 104-109
DOI: 10.1055/s-2008-1063569
© Thieme Medical Publishers

Alloplast as an Alternative for Dorsal Augmentation

Thomas J. Hubbard1
  • 1Private Practice, Virginia Beach, Virginia
Further Information

Publication History

Publication Date:
18 April 2008 (online)

ABSTRACT

With an ever increasing ethnic population in the United States, dorsal augmentation has become a fairly common accompaniment to rhinoplasty. But procurement of adequate graft material of suitable nature and amount persists as a challenge to plastic surgeons. This dilemma has become even more pressing in recent years as a variety of other exceptional graft applications for the patient's limited cartilage bank have become not just an option but also mandatory for our higher expectations. The debate of the past century over alloplast in the dorsum persists in the present. “When and if ever” is the commonly asked question. Surely, no alloplast can match the ideal graft, but no graft is ideal either as it always comes in limited supply. There is now more than 15 years of experience with expanded polytetrafluoroethylene in the nose. It appears that with proper patient selection and technique, expanded polytetrafluoroethylene can be used in the nasal dorsum with relatively low complication rates and high patient satisfaction.

REFERENCES

  • 1 Gunter J P, Clark C P, Friedman R M et al.. Dorsal augmentation: autologous rib cartilage. In: Gunter JP, Rohrich RJ, Adams WP Dallas Rhinoplasty: Nasal Surgery by the Masters. St. Louis, MO; Quality Medical Publishing Inc 2002: 513-527
  • 2 Toriumi D. Secondary Rhinoplasty. Presented at Advances in Rhinoplasty June 26-30, 2005 Chicago, Illinois;
  • 3 Adams W P, Rohrich R J, Gunter J P, Clark C P, Robinson J B. The rate of warping in irradiated and non-irradiated homograft rib cartilage: a controlled comparison and clinical implications.  Plast Reconstr Surg. 1999;  103 265-270
  • 4 Sheen J H. Continuing quest for the ideal dorsal graft.  Plast Reconstr Surg. 1998;  102 2490-2493
  • 5 Erol O. The Turkish delight: a pliable graft for rhinoplasty.  Plast Reconstr Surg. 2000;  105 2242-2243
  • 6 Daniel R K, Calvert J W. Diced cartilage grafts in rhinoplasty surgery.  Plast Reconstr Surg. 2004;  113 2156-2171
  • 7 Lewis R P, Schweitzer J, Odum B C et al.. Sheets, 3-D strands, tri-dimensional (3-D) shapes, and sutures of either reinforced or non-reinforced expanded polytetrafluoroethylene for facial soft-tissue suspension, augmentation, and reconstruction.  J Long Term Eff Med Implants. 1988;  8 19-42
  • 8 Panossian A, Garner W L. Polytetrafluoroethylene facial implants: 15 years later.  Plast Reconstr Surg. 2004;  113 347-349
  • 9 Adamson P. Implants in Rhinoplasty. Presented at Advances in Rhinoplasty June 24-29, 2003 Chicago, Illinois;
  • 10 Conrad K, Gillman G. A six-year experience with the use of expanded polytetrafluoroethylene in rhinoplasty.  Plast Reconstr Surg. 1998;  101 1675-1683
  • 11 Godin M S, Waldman S R, Johnson C M. The use of expanded tetrafluoroethylene (Gore-Tex) in rhinoplasty: A six-year experience.  Arch Otolaryngol Head Neck Surg. 1995;  121 1131-1136
  • 12 Godin M S, Waldman S R, Johnson C M. Nasal augmentation using Gore-Tex, a ten-year experience.  Arch Facial Plast Surg. 1999;  1 118-121
  • 13 Hubbard T J. Bridge narrowing in ethnic noses.  Ann Plast Surg. 1998;  40 214-218
  • 14 Johnson C M, Wyatt C T. A Case Approach to Open Structure Rhinoplasty. Philadelphia; Elsevier Saunders 2005: 612-641
  • 15 Papal I. How I do it: Correcting the Saddle Nose Deformity. Presented at Advances in Rhinoplasty June 26-30, 2005 Chicago, Illinois;

Thomas J HubbardM.D. F.A.C.S. 

Private Practice

329 Phillips Ave., Virginia Beach, VA 23454