Ultrasonographic Monitoring of Implant Thickness after Augmentation Rhinoplasty with Expanded Polytetrafluoroethylene

Abstract

Expanded polytetrafluoroethylene (ePTFE), or Gore-Tex (W.L. Gore & Associates, Flagstaff, AZ), is widely used in augmentation rhinoplasty, and the histological changes that it undergoes in the human body have been studied for decades. However, changes in the thickness of ePTFE after its use in augmentation rhinoplasty with a noninvasive object method are not well understood. We report the results of 19 patients (10 male and 9 female patients) who had undergone an uncomplicated augmentation rhinoplasty with Gore-Tex. Ultrasonography was used to evaluate changes in the thickness of Gore-Tex implants and to detect inflammatory reactions around the implants 9-67 months after surgery. Gore-Tex implants were clearly distinguishable from the surrounding tissue with ultrasonography. The postoperative thickness of the implant was decreased by 29%. There was no significant correlation between the degree of change in implant thickness and the length of time after surgery. However, the amount of thickness reduction was associated with the implant's initial thickness at the time of the surgery (R = 0.448; p = 0.001). In addition, four patients (21%) showed fibrosis or granuloma formation around the implant that was detectable via ultrasonography. Gore-Tex implants lost thickness after nasal dorsal augmentation in proportion to their initial thickness, and ultrasonography was useful for evaluating changes in Gore-Tex thickness.