Soft implants preferable for nose augmentation

Aug 6 2012

By MedWire Reporters

Soft implants are superior to hard implants for dorsal nasal augmentation, research shows.

In aesthetic and reconstructive rhinoplasty, soft implants resulted in fewer complications and higher satisfaction rates than hard implants, report investigators.

"With proper preoperative assessment and selection, excellent aesthetic and psychosocial outcomes can be expected," report Mohamed El-Shazly and Hamza El-Shafiey (Assiut University Hospitals, Egypt) in the journal Aesthetic Plastic Surgery.

Dorsal nasal augmentation is used in cosmetic rhinoplasty and in post-traumatic and congenital reconstruction. The goal of the implant, which should be biocompatible, nonabsorbable, and not cause an inflammatory response, is to achieve an optimally aesthetic and symmetrical result.

While there is some debate about the best type of implant, specifically whether it should be biologic or synthetic, El-Shazly and El-Shafiey wanted to determine whether a soft or hard nasal implant achieved the best results.

In their study, conchal cartilage grafts, septal cartilage grafts, and Medpor synthetic grafts were categorized as hard implants and implanted in 15 patients. The soft implants, used in 13 patients, included diced auricular cartilage wrapped in Surgicel sheets and dermofat blocks obtained from the groin and rolled into sutured Prolene mesh pieces.

In the early postoperative period, defined as the first 6 months following surgery, there was no difference in outcomes between patients who received the soft and hard implants. Edema, erythema, skin darkness, and mild infection were comparable and all managed using topical or systemic methods.

Based on the opinions of the surgeons and patients, the procedures were classified as satisfactory or unsatisfactory, a measure that included the maintenance of volume, resistance, and stability of the implants.

All 13 patients who received a soft implant reported being satisfied with the surgery results, whereas just 10 (66.7%) patients who received a hard implant were satisfied with the procedure. The reasons for dissatisfaction included two cases of implant deviation, two cases of implant visibility, and one case of partial resorption of the implant.

Overall, the researchers state that the soft implant is better able to achieve a dorsum with a smoother contour and pad. The soft implants were used for both fine and coarse applications with "satisfying results," they note.

While there is no difference in applying either of the two implants, write El-Shazly and El-Shafiey, the soft implants are "malleable and moldable, presenting a dough-like manipulation in dorsal reshaping."

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