Implants in rhinoplasty are not uncommon and they have been used for ages. Implants not only help in augmentation of the nose but also play an important part in correcting the deformities caused because of previous Rhinoplasties or trauma injuries.
Among the most common of implants in the recent times Porous Polyethylene Implants has gained a lot of popularity. The use of Porous Polyethylene Implants is not limited to use as implants in Rhinoplasty but it is also used in chin augmentation and ear reconstruction. One of the most useful uses of the same is in case of burnt ears. Especially in the cases of revision Rhinoplasty porous polyethylene implants give the surgeon the flexibility to model the implant to suit the nose the best. Autogenous implants lack in terms of availability, difficulty in shaping the graft and morbidity.
Implants in Rhinoplasty are not an easy operation to perform because there are several limiting factors such as the thinness or thickness of the skin, availability of the tissue and damage done because of pervious injuries.
What is Porous Polyethylene (PE) Implants?
PE implants are made up from high density, inert, non-absorbable and non-antigenic material. The pore size can range from between 160 to 368 micro meters.
Are you a candidate for Porous Polyethylene (PE) Implants?
Only after a thorough examination of the patient’s medical history can the surgeon ok them for Rhinoplasty. In order to determine the need of implants the surgeon will perform a thorough scan of the present condition of the nose. Patient’s expectations are also considered when deciding what type of implant is needed and what will be suitable. Different options are discussed in detail.
The use of PE implants in not limited to raising the height of the nose and tip definition, it can also be used for septal extension graft, spreader graft and columellar strut.
Methods used in PE implants
Rhinoplasty operations for installing PE implants are generally done as an open approach with general anaesthesia. First, the septal deviation if present is corrected and the PE sheets are prepared according to the size and requirement for the nose. For example if it is for the spreader graft the implant in Rhinoplasty will be placed on the dorsal side and for septal extension the implant is carved to give the ideal projection and rotation to the tip of the nose. The PE implants are fixed using sutures.
Various surgical techniques are used for installing Porous Polyethylene (PE) Implants in Rhinoplasty. These include Single-Plate Columellar Strut, Double Plate Columellar Strut and Butterfly shaped Strut. The single plate implant is used in normal augmentation, the double plate is used in cases of cleft lip nasal Rhinoplasty and the butterfly shaped strut is used to treat the nasal areas where double plate have already been used.
Traditionally, rib cartilages were used as struts, but in Asian patients, the rib cartilages are not enough and therefore PE implants were needed to provide the adequate tip support. Porous Polyethylene Implants are rigid enough to provide strength to the existing structure and have high resorption rate. Another advantage is that they have good biocompatibility and therefore chances of allergies and infections are minimalized. Because of the micro pores tissues can grow into them and therefore these implants gain extra stability. However the disadvantage associated with the same is that Porous Polyethylene Implants can be difficult to remove later on. The necessity to remove them mostly arises as the persona ages and the skin and tissue tone changes. By using sutures to cover up the strut and using screws to fix it on the nasal spine can help prevent displacement to a great extent. Porous Polyethylene Implants have turned out to be an excellent alternative for implants in Rhinoplasty worldwide.