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Published on: June 20, 2018
A Hybrid Auricular Cartilage-ePTFE Technique for Limited Nasal Lengthening and Augmentation in Selected Primary Han
Caiyue Liu1, Xiaoxiao Zhang2, Feng Zhou3
1Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong, University, School of Medicine, Shanghai, 200011, China. yueyue1888@hotmail.com.
Background:
Augmentation rhinoplasty is commonly performed in Han Chinese patients. Although costal cartilage provides abundant graft material, its harvest increases operative complexity and donor-site morbidity. This study evaluated a selective hybrid technique combining autologous auricular cartilage with an expanded polytetrafluoroethylene (ePTFE) implant for dorsal augmentation, limited nasal lengthening, and tip refinement in carefully selected primary patients.
Objectives:
To evaluate postoperative anthropometric outcomes and implant-related complications associated with a hybrid technique using an ePTFE implant for dorsal augmentation and limited nasal lengthening, combined with auricular cartilage grafting for tip support, contour refinement, and distal implant shielding.
Methods:
This retrospective case series included 137 female Han Chinese patients with mildly short or near-normal noses who underwent primary rhinoplasty between December 2016 and July 2022. Only patients with a minimum follow-up of 24 months were included in the clinical analysis. All patients received a custom-carved I-shaped ePTFE implant for dorsal augmentation and limited nasal lengthening support, together with unilateral auricular cartilage grafting for tip modification. Standardized preoperative and postoperative anthropometric measurements were compared using paired t tests.
Results:
Follow-up ranged from 24 to 60 months, with a mean duration of 36.2 months. Complications included implant deviation requiring revision in 3 patients, 2.2%, early postoperative infection in 2, 1.5%, late infection in 1, 0.7%, and inadequate dorsal height or tip projection in 6, 4.3%. Mean nasal length increased from 43.0 ± 1.9 mm preoperatively to 45.0 ± 1.8 mm postoperatively, P < 0.05. Mean nasal tip projection increased from 19.0 ± 1.6 mm to 23.0 ± 1.7 mm, P < 0.001. Mean nasolabial angle changed from 100.7 ± 5.33° to 98.2 ± 3.43°, P < 0.05. No implant extrusion was observed during the available follow-up period.
Conclusions:
In selected primary Han Chinese patients, this hybrid ePTFE-auricular cartilage technique may be a useful option for dorsal augmentation, limited nasal lengthening, and tip refinement. The approach may help achieve aesthetic goals in mild cases without routine costal cartilage harvest. However, the findings should be interpreted within the context of a retrospective case series with a minimum 24-month follow-up, and longer follow-up is required to further evaluate delayed implant-related complications and the durability of aesthetic outcomes.
Level Of Evidence Iv:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
