Combined silicone and cartilage implants: augmentation rhinoplasty in Asian patients

Various alloplastic materials are used for nasal augmentation in Asian patients. Of these, silicone is the most prevalent because it is durable and facilitates sculpting. However, silicone grafts have been associated with complications, including tip extrusion, infection, and graft shifting. Often the nasal tip is involved, with skin discoloration and possible implant extrusion due to increased mechanical pressure. Autogenous material provides a safer alternative for nasal augmentation, but the supply of septal or auricular cartilage in Asian patients is limited. To augment optimally and reduce extrusion risk, we use auricular cartilage grafts at the nasal tip and silicone implants for the nasal dorsum in Asian patients. We report the results of this technique in 100 Asian patients with up to 5 years of follow-up. Patients were extremely satisfied, and no implant extrusions resulted. Other complications included further surgical revision due to misalignment of the silicone dorsal implant (5 patients), tip graft shifting (2 patients), and recurrent dorsal edema over the implant requiring removal (1 patient).