Asian Rhinoplasty has become extremely popular over the past ten years. Though the actual primary concepts of numerous rhinoplasty practices apply equally in to the Asian nose, Asian rhinoplasty is distinctive because of its unique anatomy and ethnicity. Common techniques employing alloplastic implants with endonasal procedure are improving due to the advent of latest beauty concept, introduction of new techniques, and development of recently superior equipment.
On this article, we will highlight a few of the recent developments of Asian nose surgery with focus on dorsal augmentation and graft or implant materials.
Dorsal Augmentation
Autogenous grafts including cartilage, bone, and fascia are commonly perceived as the most suitable graft materials in rhinoplasty. From the autogenous graft types, autologous cartilage is largely established as well suited for dorsal augmentation because it is easy to carve, includes a high degree of tissue tolerance, a minimal infection rate, and it is readily available. Yet, cartilaginous dorsal nasal grafts are associated with limitations, such as limited amounts of tissue, additional surgery time, donor site morbidity, visible graft contour, postoperative distortions, and deformities at the graft-host interface.
Grafts and implants for Rhinoplasty
A number of different materials are available to augment the nose. Available augmentation materials could be categorized as autologous grafts and nonautologous graft materials. Autologous materials contain bone, cartilage, or both harvested from the nasal septum, ear, rib, and calvaria. Furthermore, a recent update described usage of the inferior turbinate. The utilization of tensor fascia lata has been described. The leading nonautologous materials incorporate Medpor, silicone, silastic, GORE-TEX, as well as the human acellular dermis product marketed as AlloDerm or porcine acellular dermal product marketed as Permacol or Stratus. Opinions regarding the indications for and outcomes with using these materials vary.
Augmentation rhinoplasty of the Asian nose may be effectively accomplished with alloplastic materials. Alloplast materials can be classified as porous versus solid. Pores permit tissue ingrowth, with the larger showing more aggressive ingrowth. Significant advancements in biomaterial science and implant technology in the late twentieth century led to the increased use of implants in facial surgery.
- Silicone- is a polymer of silicone-oxygen chains crosslinked by methyl side groups. The degree of cross-linking determines the physical state of silicone, ranging from a viscous gel to a rubbery solid. The solid implant provides excellent structural support. This was the first alloplast to achieve widespread use in facial cosmetic surgery. Nonporous and surrounded by a thin capsule after implantation. When Asian rhinoplasty surgeon is working on the bridge of the nose, silicone plastic bridges are typically considered.
- Injectable implants- are used for volumetric filling of small defects. Silicone injection fell out of favor when it was found to be associated with adverse reactions, including granuloma formation, chronic inflammation, and other local tissue changes. The gel is eliminated from the body and replaced with collagen and fibrin within.
