Material Selection for Rhinoplasty

Rhinoplasty is one of the common procedures in plastic and cosmetic surgery. Rhinoplasty materials can be divided into three categories: autologous materials, allogeneic materials or heterogeneous materials, and tissue substitutes. Autologous materials include autologous rib cartilage, iliac bone, etc. The advantages of these materials are that they have no risk of rejection and are extremely compatible with the nasal tissues, but the disadvantages are the surgical scar left in the area where the materials are taken, and the structural defects, and the function of the materials is also affected to a certain extent, so they should be used with caution, taking into account the fact that rhinoplasty is only for the purpose of improving the external appearance, and is not necessary for treating the disease. Allogeneic or heterogeneous materials refer to bone or cartilage materials of other people or animals, such as bovine septal cartilage. At present, the material processing is still not fully mature, and the material has some absorption after surgery, which is under research. The use of tissue substitutes (biomedical materials) for rhinoplasty is currently the most commonly used method. Commonly used materials (and prosthesis) are introduced as follows: 1, solid polymer materials: 1, silicone rubber: silicone rubber has good elasticity, easy to shape, chemically inert, non-toxic, non-carcinogenic, non-teratogenic, and good compatibility. Implanted in vivo, the local is a mild transient inflammatory reaction, the later in its surrounding the formation of a thin layer of fiber capsule. At present, it is a kind of material with the most application and better effect in rhinoplasty. Silicone rubber can be prefabricated into a variety of shapes and models of nasal prosthesis with nasal tip, nasal wings, nasal columella, and so on, and there are two commonly used ones: willow leaf shape and “L” shape. Polytetrafluoroethylene Polytetrafluoroethylene is resistant to high and low temperatures, chemical stability, corrosion resistance, good tissue compatibility, non-toxic, non-carcinogenic, non-teratogenic. Compared with silicone rubber, expanded polytetrafluoroethylene Gore-Tex as a rhinoplasty material has the following advantages: (1) softer than silicone rubber, more natural after surgery. (2) No “transparency” of silicone rubber. (3) Tissue can grow into the material, long-term fixed better. (4) Lower chance of wear out due to excessive tension. Disadvantages: (1) Intraoperative molding is required. (2) Due to insufficient hardness, it is used to support the nasal columella and nasal tip with poor results. (3) Need to prevent shape change before postoperative healing. (4) Higher price. 3, high-density polyethylene high-density polyethylene Medpor for porous solid, tissue can grow into it, biocompatibility is better. There is a certain degree of flexibility and relative incompressibility, can be carved or heated plasticizing. Second, hydroxyapatite (artificial bone): commonly used for rhinoplasty injection particles. After injection can be shaped, its excellent histocompatibility, non-toxic, non-carcinogenic, non-aging, no rejection. Disadvantages: the texture is a little hard, after shaping the recent shape is not stable, in case you need to take out more difficult. In short, after a long period of experimental research and clinical practice, most scholars believe that simple cosmetic rhinoplasty can be preferred to medical silicone rubber and polytetrafluoroethylene and other polymer materials, the effect is good; complex saddle rhinoplasty is still autologous cartilage or iliac bone is appropriate.