Porous high-density polyethylene implants (Medpor) for nasal dorsum augmentation

Abstract

Background: As rhinoplasty techniques are refined, the search for a permanent augmentation material continues. Use of autologous material creates a donor site deformity, and the material may be phagocytized over a period of time. Use of alloplastic materials often results in extrusion and infection. Objective: The purpose of this study was to examine the results of nasal augmentation using porous high-density polyethylene implants. Methods: A Medpor porous high-density polyethylene implant is carved to the approximate desired size and contour. A pocket is made in the dorsum, and sometimes over the caudal border of the septum, to accommodate the dimensions of the implant. The implant is fitted, removed, trimmed, and refitted until the precise desired contour and position are attained. The implant is rinsed in antibiotic solution and placed in position. The mucosal surfaces are closed with absorbable sutures. Results: Over the last 12 years, this technique has been used with satisfactory results in more than 30 patients. Two implants were subsequently removed because of partial implant exposure and possible infection. There were no other significant complications. Four typical cases are presented with up to 12 years of follow-up. Conclusions: When substantial strength is needed, porous high-density polyethylene implants may be used for dorsal augmentation or correction of dorsal defects with satisfactory long-term results and limited complications.