Silicone-Polytetrafluoroethylene Composite Implants for Asian Rhinoplasty.

Abstract

Silicone and Gore-Tex implants are mainstays of Asian rhinoplasty. Silicone implants are inexpensive and wieldy, but may elicit a foreign-body reaction and are prone to migration. Gore-Tex implants are more biocompatible and capable of ingrowth but expensive. Silicone-polytetrafluoroethylene (PTFE) composites have a silicone core and PTFE liner. Composite implants have been marketed for several years, but are not yet established alternatives for rhinoplasty because of a lack of relevant reports. From February 2012 to June 2015, 177 Asian patients underwent primary (n = 63) or secondary (n = 114) rhinoplasty using an I-shaped composite implant. One hundred fifty-nine women and 18 men were 19 to 72 years old (mean, 34 years) at the time of surgery. Composite implants were 1.5 to 5 mm thick and 3.8 to 4.5 cm long. Autologous cartilage from the septum, concha, or both was used for tip refinement in every case. Glabellar augmentation was performed in 19 (10.7%) cases. Follow-up was 6.0 months (range, 1-36 months). There were 19 (10.7%) complications including malposition/deviation (4.5%), erythema (2.3%), and infection (1.1%). Four patients were unsatisfied, citing inadequate dorsal height correction. There was an 8.8% revision rate; 7 of 12 revisions were for malposition/deviation. We did not observe implant step-offs or extrusion. There were no differences in outcomes after primary or secondary rhinoplasty, although there was a trend toward higher infection rate after primary rhinoplasty (P = 0.06). I-shaped silicone-PTFE composite implants are feasible for both primary and secondary augmentation rhinoplasty in Asians. Early outcomes data suggest an overall complication rate that is comparable to PTFE alone.