The use of alloplastic materials in rhinoplasty surgery: a meta-analysis.

Abstract:

BACKGROUND:Conventional wisdom regarding the use of alloplastic materials in rhinoplastic surgery would advise against their use because of safety and aesthetic concerns. However, autogenous tissue harvest is not without associated morbidity and may be inadequate or insufficient in some clinical situations. Prior studies examining this issue have not provided definitive recommendations regarding implant selection, ideal locations in which to use specific implants, and necessary follow-up. METHODS:First, the authors systematically reviewed the available literature on alloplastic implant use in rhinoplastic surgery by searching the MEDLINE database (from 1966 through September of 2005). Bibliographies from retrieved articles were searched for additional references. All data were independently extracted by two coauthors. Second, the authors performed a meta-analysis of the three most commonly used implant types. RESULTS:Although a wide variety of alloplastic materials have been used historically and are still currently available, the most commonly used materials are silicone, expanded polytetrafluoroethylene (Gore-Tex), and porous high-density polyethylene (Medpor). In our meta-analysis, the removal rate for both Gore-Tex and Medpor implants was 3.1 percent, whereas the removal rate for silicone implants was significantly higher at 6.5 percent. CONCLUSIONS:Alloplastic implants in rhinoplastic surgery have acceptable complication rates and can be used when autogenous materials are unavailable or insufficient. Outcomes with Medpor or Gore-Tex implants may be slightly better than those with silicone. Improved reporting of implant failures and follow-up times in future studies are needed to better define specific guidelines for the use of these materials.

journal_name

Plast Reconstr Surg

authors

Peled ZM,Warren AG,Johnston P,Yaremchuk MJ

doi

10.1097/01.prs.0000299386.73127.a7

subject

Has Abstract

pub_date

2008-03-01 00:00:00

pages

85e-92e

issue

3

eissn

0032-1052

issn

1529-4242

pii

00006534-200803000-00043

journal_volume

121

pub_type

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