Implants and grafts in secondary rhinodeformities.

Area of Science:

• Plastic Surgery
• Otolaryngology
• Reconstructive Surgery

Background:

• Secondary rhinodeformity often results from excessive resection during primary rhinoplasty.
• Management strategies include alloplastic implants and autologous cartilage grafts.

Purpose of the Study:

• To evaluate the long-term outcomes of different surgical techniques for secondary rhinodeformity.
• To compare the efficacy and complications of silicone implants versus cartilage autografts.

Main Methods:

• A retrospective review of 1359 cases of secondary rhinodeformity treated over 15 years.
• Surgical interventions included preshaped silicone (Silastic) implants, combined implant and graft procedures, and exclusive cartilage autograft reconstruction.
• Cartilage grafts were sourced from the nasal septum and auricular pavilion.

Main Results:

• The study observed a shift in surgical preference over three 5-year periods.
• Initial reliance on silicone implants evolved towards combined techniques and finally to exclusive use of cartilage autografts.
• Disadvantages associated with silicone implants were noted, leading to their eventual abandonment.

Conclusions:

• Cartilage autografts demonstrate superior outcomes and fewer complications for secondary rhinodeformity correction compared to silicone implants.
• The investigators strongly advocate for the exclusive use of cartilage autografts in revision rhinoplasty procedures.