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Dorsal Augmentation with AlloDerm.

Joseph M Gryskiewicz¹

¹University of Minnesota Academic Health Center, School of Dentistry, Cleft Palate and Craniofacial Clinics, Minneapolis, Minnesota.

Seminars in Plastic Surgery

|June 23, 2010

Summary

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AlloDerm, a cadaver dermis graft, offers a viable alternative to cartilage in rhinoplasty, particularly for revision surgeries. While it avoids donor site issues and irregularities, surgeons must account for 20-30% resorption, especially over the bony dorsum.

Area of Science:

Plastic Surgery
Regenerative Medicine
Biomaterials

Background:

Nasal skin contraction variability necessitates augmentation in rhinoplasty.
Autogenous cartilage grafts, while common, present challenges like graft depletion and long-term irregularities, especially in revision cases.
Alternative soft tissue substitutes are being explored to address these limitations.

Purpose of the Study:

To evaluate AlloDerm, a freeze-dried acellular cadaver dermis, as a soft tissue substitute in nasal augmentation.
To assess the efficacy and safety of AlloDerm in balancing the nasal skin envelope and adhering to the augmentation-reduction principle.
To compare AlloDerm with traditional autogenous cartilage grafts, highlighting its advantages and disadvantages.

Main Methods:

Keywords:

AlloDerm dorsal augmentation dorsal graft dorsum rhinoplasty

Related Experiment Videos

AlloDerm was utilized as a filler material to expand the nasal skin envelope in rhinoplasty procedures.

Placement techniques considered its pliable nature for use under thin skin.

Clinical outcomes were observed, focusing on graft integration, stability, aesthetic irregularities, and resorption patterns.

Main Results:

AlloDerm serves as an effective filler, expanding the nasal skin envelope and facilitating touch-ups.
It obviates the need for graft harvest, eliminating donor-site morbidity associated with cartilage, bone, or rib grafts.
While generally stable, AlloDerm exhibits 20-30% resorption, primarily over the bony dorsum, necessitating overcorrection. No further resorption was noted after one year.

Conclusions:

AlloDerm is a safe and effective alternative soft tissue substitute in rhinoplasty, particularly for revision patients or those requiring dorsal augmentation.
Its use eliminates donor-site complications and long-term irregularities associated with autogenous grafts.
Surgeons must consider and plan for graft resorption, especially over the bony dorsum, to achieve optimal and stable aesthetic results.