How to choose rhinoplasty materials?

There is a wide variety of filling materials for rhinoplasty, each with its own advantages and disadvantages. They can be divided into two categories: autologous tissues and synthetic materials. Autologous tissues include auricular cavity cartilage, nasal septal cartilage, rib cartilage, rib bone, iliac bone, cranial bone, fibula, free fat, and dermal tissue. Synthetic materials include ivory, solid silicone rubber, expanded polytetrafluoroethylene, porous high-density polyethylene, hydroxyapatite, decellularized dermis, and allogeneic collagen preparations. The most widely used autologous biomaterials are auricular cavity cartilage, nasal septum cartilage, and rib cartilage. The cartilage of the auricular cavity is the softest and has a certain curvature, so it is safe enough to be used as the ideal material for shield-type graft filling of the nasal tip, and is most suitable for patients with thick skin and weak cartilage at the tip of the nose, who need to increase and lengthen the tip of the nose and have more concerns about artificial materials. The septal cartilage is slightly harder than the cartilage of the auricular cavity, and it is in the form of a flake, which can be easily trimmed and processed into a filling material for the nasal column as a support, and it can also correct the bent and skewed septum, which is most suitable for patients with a crooked nose involving a deviated septum, unilateral cleft lip and palate nasal deformity, short nasal column and lack of support at the tip of the nose. The advantage of rib cartilage is that there is an adequate amount of donor area, but it takes more time to take and sculpt the material during surgery, and it is more damaging to the donor area, usually leaving visible scars. Autologous materials have a 20-40% absorption rate, so it is difficult to control the size of the material. Currently, the commonly used synthetic materials are solid silicone rubber, expanded polytetrafluoroethylene, porous high-density polyethylene, etc. Most other materials are eliminated or rarely used. In our country is still the most widely used silicone rubber, one is because the price is moderate; the second is the material characteristics of easy to operate; the third is due to the long history of silicone applications, doctors have the traditional concept and technology habits also make silicone rubber occupy a huge market. Expanded polytetrafluoroethylene has also been widely used in recent years because of its high tissue compatibility, stable nature and natural effect. Compared to silicone, it is less elastic and can be completely fitted with the body. It also does not tend to make the soft tissue of the skin thin and translucent. However, the disadvantage of expanded PTFE is that it is relatively expensive and has an increased risk of chronic inflammation in the long term due to the presence of microporosity. And once the need for secondary surgery to adjust the situation, the removal of the prosthesis to the tissue damage is significantly greater than the silicone prosthesis.